0855.000.00 Ticket to Work Health Assurance (TWHA) Program

0855.005.40 Income

IM-106 December 28, 2023; IM-77 August 28, 2007

The Ticket to Work Health Assurance (TWHA) program considers income for employed disabled persons of up to 250% of the Federal Poverty Level (FPL).

Note: Earned income of the disabled worker from 250% to 300% of the FPL is disregarded. If the participant is above 300% of the FPL, this income disregard is not applied as the participant is not eligible.

A TWHA participant’s need is determined as a single individual or a married couple. Review TWHA Couple Cases to determine eligibility for couples.

Disregards for income determinations:

  • First $50,000 of the disabled worker’s spouse’s annual earned income.
  • Twenty dollar standard exemption.
  • Health insurance premiums.
  • Seventy-five dollar a month standard deduction for the disabled worker’s dental and optical insurance when the total dental and optical insurance premiums are less than seventy-five dollars. If the total dental and optical insurance premiums exceed $75, allow the actual premium.
  • Supplemental Security Income (SSI).
  • The first fifty dollars ($50.00) of the disabled worker’s Social Security Disability Insurance (SSDI).
  • Standard deduction for impairment-related employment expenses equal to one-half of the disabled worker’s earned income. The disabled worker is entitled to this deduction even if the earned income is excluded from the gross income test as sheltered workshop income.

Income earned from retirement accounts is considered as income up to 250% FPL.

Refer to MHABD Appendix J for the current TWHA income maximums. Individuals cannot spend down to obtain this coverage. Individuals with income above the monthly income maximum are not eligible for TWHA.

Income Exclusions are allowed for the MO HealthNet Program as outlined in 0805.015.10 Income Exclusions.

Note: Exclude any income earned by individuals eligible for certified extended employment at a sheltered workshop. This exclusion applies to income earned at both a sheltered workshop and a different employer when the individual is certified for extended employment at a sheltered workshop.