Document Sample
Comm Powered By Docstoc
					  MEDICAID FOR EMPLOYED                             You will be required to pay a monthly                  You must meet all other eligibility criteria for
                                                     premium when your monthly gross income                  SSI-related Medicaid.
                                                     is above 150% of the federal poverty level             You will receive a Notice of Decision that
          (MEPD)                                     (currently $1,123). (Premiums are                       will tell you the amount of your premium and
                                                     calculated based only on the gross income               the six-month premium period.
Medicaid for Employed People with Disabilities       of the disabled individual.) Premiums must
                                                                                                            A set premium amount is established for six
(MEPD) is a Medicaid coverage group                  be paid before you can receive Medicaid.
                                                                                                             months at a time.
implemented to allow persons with disabilities      Your countable resources must be $12,000 or
to work and continue to have access to medical                                                                   The premium amount cannot be increased
                                                     less for an individual and $13,000 or less for
assistance.                                                                                                       due to an increase in income in the six-
                                                     a couple.
                                                                                                                  month period.
Are you eligible?                                     Some resources are exempt from consideration               The premium amount can be decreased if
To qualify:                                           for all SSI-related Medicaid coverage groups.               income goes down.
 You must be disabled. If you receive the            There are additional resources that are               What happens when I have to pay a
  following you will be considered disabled           exempt from consideration for eligibility for         premium?
  for MEPD:                                           MEPD. They are:
                                                                                                           A billing statement will be sent to you with all
       Supplemental Security Income because              Retirement accounts held by the
       you are disabled;                                                                                    months for which you have been approved and
                                                          disabled individual such as simplified
                                                                                                            there is a payment due. When the bill is for
      Social Security Disability; or if your             employee pension plans, self-employ-
                                                                                                            more than one month, the premium amount or
                                                          ment pension plans, Keogh plans,
      Social Security Disability benefits have                                                             due dates may vary. Read the billing
                                                          individual retirement accounts, Roth
       stopped due to earned income but you                                                                 statement carefully.
                                                          individual retirement accounts, savings
       continue to be eligible for Medicare.
                                                          incentive matched plans for employees            Premiums are due as follows:
      If you are not receiving these benefits            and similar plans for retirement.                 The premium for the month you are approved
       you may also qualify as disabled if your
                                                         Funds in assistive technology accounts,            will be due the 14th of the month following
       disability meets the medical criteria
                                                          which are funds saved for the purchase,            the month of approval.
       used to establish disability for benefits
                                                          lease or acquisition of assistive technology,     The months following the month in which
       administered by the Social Security
                                                          assistive technology devices, or assistive         you are approved are called ongoing months.
       Administration. The Department of
                                                          technology services. To be exempt a                Ongoing month’s premiums will be due the
       Human Services will make a determination
                                                          physician, certified vocational rehabilitation     14th of the month the premium is to cover.
       about your medical impairments.
                                                          counselor, licensed physical therapist,
 You must be under age 65.                               licensed speech therapist, or licensed            Any months earlier than the month on the
 You must have earned income from                        occupational therapist must establish the          notice that approves you, will be due the
  employment or self-employment.                          need for such technology and that the              14th of the third month from the month of
                                                          technology can reasonably be expected              approval.
 Monthly net family income must be less
                                                          to enhance the individual’s employment.           All premiums will be billed for four months.
  than 250% of the federal poverty level for
  your family size. Net income is your gross             Funds placed in a medical savings                What happens when I do not pay the
  family income less exclusions and disregards.           account that is exempt from federal              premiums?
  The DHS office will advise you about                    income taxation pursuant to Section 220           A medical card is not issued unless the
  disregards and deductions.                              of the United States Internal Revenue               premium is paid.
                                                          Code (26 U.S.C. § 220).
 If you do not pay an ongoing month                             How do I find out if I qualify?
  premium by the due date, your eligibility           To find out if you qualify for this coverage group,
  will be canceled. You will have to file a           you must file a Medicaid application at your
  new application to get eligibility again.           county Iowa Department of Human Services office
                                                      and complete the application process.
                                                      To find out the amount of premium you would be
      Your eligibility can be reinstated if your     expected to pay, total your gross earned income
       ongoing month’s payment is received by
       the last working day of the month it is due.
                                                      and your gross unearned income and compare the        FOR EMPLOYED
                                                      amount to the chart on this form.
      Your eligibility can be reopened once in
       a six month period if the ongoing month        Remember that if you are required to pay a
                                                      premium, your premium must be paid by the due
                                                                                                            PEOPLE WITH
       payment is received in the month
       following the month it is to cover.            date in order to receive Medicaid coverage.

How are premium payments applied?                                MEPD PREMIUM CHART
Premium payments will be applied to unpaid                  If the Gross Income of    The Monthly
months in the following order:                              the Eligible person is:   Premium Is:
 If the month of receipt is not paid, the payment        $ 1,123 or Less             $              0
  will be applied to the month it is received. A
  payment received in June will be applied to               Above:     $ 1,123        $         20
  June.                                                                  1,303                  38
                                                                         1,482                  56
 If the premium has been paid for the month,
  then we determine if the payment was received                          1,662                  74
  in the last five workdays of the month.                                1,841                  92
                                                                         2,021                 110
 If the payment was received in the last five
  workdays of the month, the payment is applied                          2,201                 128
  to the month after the month of receipt. A                             2,380                 146
  payment received in the last five workdays of                          2,560                 164
  June will be applied to July.                                          2,739                 182
 If the month after the month the payment is             $ 2,919 and above                    201
  received has been paid or if the payment was
  received before the last five workdays of the       This chart is a guide only. Federal poverty levels
  month, we apply the payment to the month            are determined on an annual basis. Changes in
  before the payment was received. A payment          the poverty levels will change the income range
  received in June will be applied to May.            for premiums.
 If the month before the month the payment
  was received is paid, the payment is applied
  to the oldest unpaid month and forward.
 If there are no old unpaid months, the payment
                                                                                                               Department of
  is credited and applied to future assessed          Comm. 180 (Rev. 4/03)                 PAPER
                                                                                                               Human Services