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.
PEOPLE WITH DISABILITIES
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-
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
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
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
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
is credited and applied to future assessed Comm. 180 (Rev. 4/03) PAPER