Adult-ish kids, health insurance, and disability

**Dweezil **turns 26 in about 2 months.

Moon Unit turned 23 earlier this year.

Both are still covered under our health insurance, though Dweezil is, obviously aging out in 2 months (well, December actually, as the employer-sponsored insurance is through the end of the calendar year).

Both of my kids are special-needs. Dweezil is autistic (though high-functioning; he drives, goes to school, has held a job etc.). Moon Unit has some mental health issues, as well as a seizure disorder (which seems to be well controlled). She has actually been approved for Medicaid in the state where she is currently living. The residential treatment facility staff helped her apply for that.

I have heard that employer-sponsored health insurance can be extended beyond age 26 if the child is declared to be disabled.

Anyone here have any experience with going through that process? I don’t know if the burden of proof is any different compared with getting Social Security disability - which my son would clearly not meet given that he held a job for several years (he resigned when he went away to college). And of course that only would last as long as one of us was employed - which is only another 5 years or so (we hope!!).

Could we have him apply for Medicaid? He has no income at the moment, and limited savings - and he can’t get a job right now with things being shut down. Well, he could - he worked part-time at a major grocery chain, and they’re hiring, but we are not encouraging it due to the risk of bringing COVID home. Plus he returns to college (perhaps) in about 10 weeks. Our state did enact Medicaid Expansion a couple years back; with his autism he might have qualified even without that.

We are trying to encourage our daughter to apply for Social Security disability. She is not earning much, and is making relatively little progress with becoming more independent; staff where she was living could provide documentation of it. In any case, she’s not nearly as urgent as her brother.

Forgot to mention: Our income is certainly above the Federal poverty limit. I don’t know if maintaining our house as his legal residence would interfere with Medicaid eligibility.

Your local Medicaid office can tell you more, as can the administrator of your benefits department.

Under expanded Medicaid, it doesn’t matter. All they take into account is his adjusted gross income. (They sometimes call it “household” income but that’s a confusing term. You and him are separate “households” even if you live together.)

Actually, this might be wrong. Do you, or are you able to, claim him as a dependent? You might be the same household in that case.

That’s a good question.

We probably will for 2019 ( we haven’t done our taxes yet, boo) because he had almost no income, so he qualifies as a dependent. We did not take him as a dependent the year before because he had more income that year.

I did some googling and it does seem that this scenario (taking someone as a dependent, while they get Medicaid) is actually allowable.