Ticket to Work Health Assurance (TWHA) Basic Eligibility Requirements

ELIGIBILITY FACTOR:

REQUIREMENT:

AGE:

Must be aged 16 through 64, including the month s/he becomes 16 or 65.

CITIZENSHIP/ALIEN STATUS:

Same as OAA, PTD, AB

SOCIAL SECURITY NUMBER:

Same as OAA, PTD, AB
Requirement applies only to the applicant or participant, not spouse or child.

RESIDENCE:

Same as OAA, PTD, AB

DISABILITY:

Basic Coverage Group: Must be PTD. Same as MHABD, but participant’s earnings are not considered in determining disability. Determined by receipt of SSDI or SSI, or by MRT decision.
Once determined PTD under MHABD or TWHA Basic Coverage Group, may switch between categories without re-determination.
Medically Improved Group: Continues to have a severe medical impairment, but lost Basic Coverage Group eligibility due solely to improvement in medical condition.

EMPLOYMENT:

Basic Coverage Group: Must have earnings with Medicare & Social Security taxes withheld; self-employed must prove payment of Medicare & SS taxes. No minimum hours or earnings required.
Medically Improved Group: Must have earnings equivalent to at least 40 hours per month at federal minimum wage and have Medicare & Social Security taxes withheld (or paid if self-employed).

RESOURCES:

Same maximums as for Non-MAGI ($5,909.25– single; $11,818.45 – couple).
Exclude medical savings accounts up to $5000 per year and earnings on deposits.
Exclude independent living accounts up to $5000 per year and earnings on deposits.

Exclude all retirement accounts

NOTE:  Resource limits increase each July 1. Prior resource limit chart.

ELECTRONIC VERIFICATION OF RESOURCES:

Must agree to authorize the State of Missouri to access the electronic asset verification system to verify assets. *

INCOME:

 Monthly Income of up to 250% of the FPL after disregards:

  • First $50,000 of the non-TWHA spouse’s annual earned income
  • $20 standard exemption
  • Health insurance premiums
  • $75 standard for dental/optical insurance premiums incurred, or actual cost if in excess of $75 (Must incur dental &/or optical premiums to qualify)
  • All SSI income
  • First $50 of the disabled worker’s SSDI income
  • Standard deduction of ½ of earnings of the disabled worker for impairment-related employment expenses, even if income is excluded (such as sheltered workshop income). No verification of expenses is required.

PREMIUM PAYMENT:

Participants with income exceeding 100% FPL must pay a monthly premium.

* Note: Missouri uses Accuity to access electronic asset verification from financial institutions.