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Medicaid for Employed People with Disabilities (MEPD Program)

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. A brochure of the following text in MS Word format may be downloaded by clicking here.

Are you eligible?
To qualify:

1. You must be disabled. If you receive the following you will be considered disabled for MEPD:
  • Supplemental Security Income because you are disabled;
  • Social Security Disability; or if your
  • Social Security Disability 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 used to establish disability for benefits administered by the Social Security Administration. The Department of Human Services will make a determination about your medical impairments.
2. You must be under age 65.
3. You must have earned income from employment of self-employment.
4. 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 size of one is currently $1,846 per month. Net income is your gross family income less exclusions and disregards
5. You will be required to pay a monthly premium when your monthly gross income is above 150% of the federal poverty level (currently $1,108). (Premiums are calculated based only on the gross income or the disabled individual.) Premiums must be paid before you can receive Medicaid.
6. Your countable resources must be $12,000 or less for an individual and $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 such as simplified employee pension plans, self-employment pension plans, Keogh plans, individual retirement accounts, Roth individual retirement accounts, savings incentive matched plans for employees and similar plans for retirement.
  • 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 the need for such technology and that 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).
7. You must meet all other eligibility criteria for SSI-related Medicaid.
8. You will receive a Notice of Decision that will tell you the amount of your premium and the six-month premium period.
9. A set premium amount is established for six months at a time.
  • The premium amount cannot 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?
A billing statement will be sent to you with all months for which you have been approved and there is a payment due.

What happens when I do not pay the premiums?
If you do not pay an ongoing month premium by the due date, your eligibility will be cancelled. You will have to file a new application to get eligibility again.

Premiums may be paid in advance.

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 office and complete the application process.

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

MEPD PREMIUM CHART
If the Gross Income of the Eligible person is:
The Monthly Premium Is:
$ 1123 or Less
$0
Above: $1123
$20
$1303
$38
$1482
$56
$1662
$74
$1841
$92
$2021
$110
$2201
$128
$2380
$146
$2560
$164
$2739
$182
$ 2919 and above
$201

This chart is a guide only. Federal poverty levels are determined on an annual basis and changes in the poverty levels will change the income range for premiums.

MEPD REPORT NARRATIVES

To help understand what is happening within the Medicaid for Employed People with a Disability program, a collection of reports have been designed. The intent of each report is to describe the enrollees by looking into an element of this program. Each report is described below and each report can be viewed or downloaded by clicking on the report name or other places as noted below.  As more information for additional months becomes available, additional reports in each category will be posted to this site.  New reports will also be posted as they are developed.

Report -- Average Income by Type

This is a graph of the income of all MEPD enrollees. There is a line showing the average earned income and the average for the unearned income. The third line is the average total earnings (both earned and unearned) of all enrollees. The expectation is that over time the unearned income line will decrease and the earned income line will increase. It will take quite some time to over come recipient's belief that higher earnings will cause the recipient problems and a loss in supports.

Report -- Comparison of Premiums to Non-Premiums

This is a graph showing what percent of the MEPD enrollees pay a premium and do not pay a premium. The data is monthly presented in a bar chart format. The first enrollees were individuals who were already working, had higher incomes, and thus gave a higher percentage of enrollees who were paying a premium. New enrollees are more likely to be individuals who have just started to work so they will have a lower level of income and thus more likely not to have a premium payment.

Report -- Growth in Enrollees


This is a graph showing the number of enrollees by month in a line graph format. It was expected that growth would be rapid in the early months of a new program and though the number of cases is continuing to grow it is at a declining rate. 

Report -- Hours of Work

This is a graph showing the percent of monthly MEPD enrollees that work in one of the three monthly hour's group. The three groups are working 0 to 10 hours per month, working 11 to 80 hours per month, and working more than 80 hours per month. The first enrollees were individuals who were already working, had higher incomes, and probably working a greater number of hours. New enrollees are more likely to be individuals who have just started to work so they will have a lower level of income and probably working less hours as they acclimate to the working environment and build confidence that they cal work at a real job.  A copy of this report in Microsoft Word format for download and printing may be found here.

Report -- MEPD Enrollees by Type and Level of Income (Monthly reports available below)

These are tables for each month of the program that shows the distribution of enrollees by type and level of income. Each row represents a different range of unearned income while each column is a different range of earned income. In each cell of the table is the number of enrollees who have that level of earned and unearned income. The bottom row shows the percentage of enrollees in each earned income range. These tables only show a snapshot of enrollees' income at a point in time. Future analysis, after 2-3 years, will look at the change in earned income (hopefully upward) over time. It is important to remember that new enrollees are probably new to the job market so they will start out at low paying jobs and few hours. The hope is that with experience both the hours and the pay will increase.  For copies of monthly reports in Microsoft Word format please click the following:  June 2002, May 2002, April 2002, March 2002, February 2002, January 2002, December 2001, November 2001, October 2001, September 2001, August 2001, July 2001, June 2001, May 2001, April 2001, March 2001, February 2001, January 2001, December 2000, November 2000, October 2000, September 2000, August 2000, July 2000, June 2000, May 2000, April 2000, March 2000

For more information about the MEPD program please contact:
Jim Overland
Phone: 515/281-8908
Fax: 515/242-6036
Email: joverla@dhs.state.ia.us

 
 

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