Kansas Working Healthy Program: Medicaid Buy-In for People with Disabilities

The Problem Working Healthy Solves

For many Kansans with disabilities, employment creates a terrifying paradox. Earning a paycheck can push income above the regular KanCare Medicaid threshold of $994 per month, which would normally trigger a loss of health coverage. Losing Medicaid means losing access to the personal care services, prescriptions, and therapies that make working possible in the first place.

Working Healthy breaks that cycle. It is Kansas's Medicaid Buy-In program, designed specifically so people with disabilities can hold a job without sacrificing their healthcare.

Eligibility Requirements

To qualify for Working Healthy, an applicant must meet all of the following:

• Age: Between 16 and 64
• Disability: Have a medically determined disability that meets SSA's definition
• Employment: Be currently employed in integrated, competitive work earning at least $65 per month, with standard FICA or SECA tax withholdings (sheltered workshop or day-habilitation activity does not count)
• Assets: Countable assets under $15,000 (significantly more generous than the standard $2,000 Medicaid limit)
• Income: Total countable income under 300% of the Federal Poverty Level

The $15,000 resource limit is one of the most overlooked advantages of Working Healthy. Under standard KanCare rules, an individual with a disability loses Medicaid eligibility once countable assets exceed $2,000. Working Healthy raises that ceiling by a factor of seven, giving employed individuals room to save.

How the Premium Works

Working Healthy is not free coverage. Participants with income above 100% of the Federal Poverty Level pay a monthly premium based on a sliding scale. The premium is modest relative to private insurance, but it is a real cost. Participants with income at or below 100% FPL pay no premium.

The trade-off is straightforward: a manageable monthly premium in exchange for full KanCare Medicaid benefits, including personal care services, prescription coverage, and access to HCBS waiver services.

The WORK Program Add-On

For individuals who need waiver-level personal care assistance to maintain their employment, Kansas offers the affiliated WORK program. This add-on layers personal attendant services on top of Working Healthy coverage.

Participants must engage in at least 40 hours of employment or work-related activity per month. The program allows earning up to 300% of the Federal Poverty Level while keeping healthcare coverage and the personal care assistance that makes employment possible.

The WORK program fills a gap that standard Working Healthy does not cover. A person might qualify for Working Healthy's medical benefits but still need hands-on support getting ready for work, transportation assistance, or on-the-job accommodations. WORK provides that layer.

How Working Healthy Connects to the Adult Transition

For young adults with disabilities who are moving from school-based services into employment, Working Healthy is a critical part of the benefits architecture. The typical sequence works like this:

1. The individual turns 18 and goes through the SSI age-18 redetermination
2. SSI approval (or a successful appeal) establishes disability status
3. A separate KanCare application secures Medicaid coverage
4. If the individual is employed or seeking employment, Working Healthy lets them earn more without losing that coverage

Working Healthy also coordinates well with ABLE accounts. Employment income can be contributed to an ABLE account under the ABLE-to-Work provision, building savings without affecting the $15,000 Working Healthy resource limit. The two programs stack: Working Healthy keeps Medicaid active while ABLE shelters earnings from the SSI resource test.

How to Apply

Applications for Working Healthy go through the KanCare Clearinghouse, the same entity that handles standard Medicaid applications. The application requires documentation of the disability, proof of employment and wages, and financial information.

Families navigating the full spectrum of adult benefits, including SSI, KanCare, CDDO waiver intake, and Working Healthy, can find the complete filing sequence in the Kansas SSI at 18 & Adult Disability Benefits Guide.

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