MEPD

Medicaid For Employed People with Disabilities

Medicaid For Employed People with Disabilities (MEPD) is a medicaid coverage group implemented to allow persons with disabilities to work and continue to have access to medical assistance.

Are you eligible?

To qualify :

you must be disabled : If you receive the following you will be considered disabled for MEPD

Supplemental Security Income (SSI) because you are disabled

Social Security Disability Income (SSDI) or

If your Social Security Disability Income (SSDI) benefits have stopped due to earned income but you continue to be eligible for Medicare.

If you are not receiving these benefits, you may also qualify as disabled if your disability meets the medical criteria to establish disability for benefits administered by the Social Security Administration (SSA). The Department of Human Services will make a determination about your medical impairments.

You must be under the age of 65

You must have earned income from employment or self-employment

Monthly net family income must be less than 250% of the federal poverty level for your family size.  250% of the federal poverty level for a family of one is $1,790 per month. Net income is your gross family income `less the inclusions and disregards.

You will be required to pay a monthly premium when your monthly gross income is above 150% of the federal poverty level, currently $10, 748 per month.

(Premiums are calculated based solely on the gross income of the disabled individual.) Premiums must be paid before you can receive Medicaid.

Your countable resources must be $12,000 or less for an individual or $13,000 or less for a couple.

Some resources are exempt from consideration for all SSI-related Medicaid coverage groups.

There are additional resources that are exempt from consideration for eligibility for MEPD.

 They are :

Retirement accounts held by the disabled individual such as, simplified employee pension plans , self-employment pension plans, Keogh plans, individual retirement accounts, Roth individual retirement accounts, savings incentive matched for employees, and similar retirement plans.

Funds in assistive technology accounts, which are funds saved for the purchase, lease, or acquisition of assistive technology,  assistive technology devices, or assistive technology services. To be exempt a physician, certified vocational rehabilitation counselor, licensed physical therapist, licensed speech therapist, or licensed occupational therapist must establish need for such technology  and the technology can reasonably be expected to enhance the individual's employment.

Funds placed in a medical savings account that is exempt from federal income taxation pursuant to Section 220 of the United States Internal Revenue Code (26 U.S.C.  § 220).

You must meet all other eligibility requirements for SSI-related Medicaid

You will receive a Notice of Decision that will tell you the amount of your premium and the six-month premium period.

A set premium is established for six months at a time.

The premium amount can not be increased due to an increase in income in the six-month period

The premium amount can  be decreased if income goes down.

What happens when I have to pay a premium?

Beginning months bill  You will receive a bill for the two months immediately following the month of approval. Payment for both months is due on the 14th of the first month following approval.

Ongoing months bill  You will be billed monthly thereafter with premiums due by the 14th of the month prior to the month the premium is to cover.

Initial  months bill  A late billing will be sent for the month of approval and any prior months in the premium period . Payment is due within 60 days.

Retroactive  months bill  You will receive a bill for the retroactive months (the three months prior to the month you filed your application) Payment is due within 60 days.

What happens when I do not pay a premium?

Beginning month   If you do not pay for the first beginning month by the due date, no Medicaid card will be issued.

If you do not pay for the second beginning month by the due date, your Medicaid  will be cancelled. If you do not pay the premiums billed for the ongoing months your Medicaid  will be cancelled.

 If you do not pay for premiums billed with 60 days to pay you will lose Medicaid eligibility for any months not paid.

Premiums may be paid in advance on quarterly or semi-annual basis for months within a premium period upon request.

How do I find out if I qualify?

To find out if you qualify for this coverage group, you must file a Medicaid application at your county Iowa Department of Human Services (DHS) office and complete the application process. (The Black Hawk County office is directly across the street from McKinstry Elementary School.)

To find out the amount of premium you would be expected to pay , total your gross earned income and your gross unearned income and compare the amount to the chart below.

Remember that, if you required to pay a premium, your premium must be paid by the due date in order to receive Medicaid coverage.   

MEPD Premium Chart