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Medicaid Buy-In Program for Workers with Disabilities (MBIWD)-Program to Increase Employment and Retain Medicaid Benefits for People with Serious Mental Illness

In April 2008, the Ohio Rehabilitation Services Commission estimated that more than 2 million, or one in five Ohioans, have disabilities.  However, the vast majority of Ohioans with disabilities are unemployed.  In fact, the employment rate among Ohioans with disabilities is 37 percent compared to 80 percent for workers without disabilities.  Many individuals with disabilities want to work and may have opportunities to work, but don’t pursue them for fear that increasing their income and savings might cause them to lose their Medicaid health care coverage.

To address this policy issue, the Medicaid Buy In for Workers with Disabilities (MBIWD) program was authorized in Amended Substitute House Bill 119 the 2008-2009 biennial budget. The MBIWD program created a new eligibility category within the Ohio Medicaid program allowing workers with disabilities to maintain Medicaid coverage while they are working earning income and establishing savings.   After income deductions, MBIWD enrollees may earn up to 250 percent of the federal poverty level.  Participants may also accrue savings of up to $10,000, a threshold which will be adjusted annually.  MBIWD participants with incomes above 150 percent of the federal poverty level may pay a monthly health care premium for their Medicaid coverage.  Nevertheless, MBIWD does encourage Ohioans with disabilities to go to work or accept more work or job promotions without risking the loss of Medicaid health care coverage .As of September, 2010, the most recent data available, 4,752 Ohioans are enrolled in MBIWD.


OhioMHAS has worked with a broad range of stakeholders to develop technical assistance documents and special reports focused on increasing participation by people with serious mental illness in the MBIWD program. Consumers, provider organizations, and others are encouraged to use the tools referenced below in efforts to get the word out on MBIWD in order to increase employment and retention of Medicaid benefits for persons with serious mental illness.

For application materials, please visit the Ohio Department of Medicaid, Medicaid Buy-in web page: