Rhode Island Sherlock Plan: Medicaid Buy-In for Working Adults with Disabilities
If you are a working adult with a disability in Rhode Island and your earnings push you above the Medicare Savings Program limits, the Sherlock Plan is Rhode Island's Medicaid Buy-In path for working adults with disabilities. MSP eligibility remains a separate determination under standard QMB or QI rules.
What the Sherlock Plan Is
The Sherlock Plan is Rhode Island's Medicaid Buy-In program for working adults with disabilities, established under the Ticket to Work and Work Incentives Improvement Act. It allows people with disabilities who are employed to maintain Medicaid coverage at higher income levels than standard eligibility rules would permit.
This matters for Medicare-eligible disabled adults because standard QMB is limited to $1,683/month in countable income, while QI has a $2,255 monthly limit. If countable income exceeds the MSP limits, ask DHS about Sherlock as a separate Medicaid buy-in; Sherlock enrollment alone does not establish QMB or QI eligibility.
Who It Is For
The Sherlock Plan targets adults who:
- Have a qualifying disability under the plan's rules
- Are currently employed and earning income
- Have income above standard Medicaid/MSP limits but within the Sherlock Plan's thresholds
- Are Rhode Island residents
The program specifically addresses the "benefits cliff" problem: disabled adults who want to work but fear losing health coverage if their income rises.
How It Connects to Medicare
Some working adults with disabilities also have Medicare through SSDI after the 24-month qualifying period. Rhode Island evaluates QMB and QI separately under the standard income and resource rules; Sherlock enrollment alone does not establish either MSP benefit. Ask DHS to assess both programs if you need help with Medicaid and Medicare costs.
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How It Differs from Standard MSP
The key differences:
Income limits. The Sherlock Plan allows higher income than standard QMB or QI. Ask DHS for the Sherlock income threshold and how it counts your earnings; do not apply the MSP calculation automatically.
Work requirement. Standard MSP has no work requirement. The Sherlock Plan requires active employment.
Premium. Standard MSP has no participant premium. Ask DHS about any Sherlock-specific cost before enrolling.
How to Apply
The Sherlock Plan is administered by DHS. If you are currently receiving SSDI and working in Rhode Island, contact DHS and ask about the Sherlock Plan / Medicaid Buy-In for Working People with Disabilities. If you also need MSP assistance, submit a separate Medicare Premium Payment Program application through HealthyRhode or at a DHS field office.
For general information on Medicare cost-sharing programs that are available regardless of employment status, the Rhode Island Medicare Savings Programs guide covers QMB, QI, Extra Help, and RIPAE eligibility.
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