M.E.D. Works
Introduction to M.E.D. Works
In July 2002, Indiana created a health care program called
M.E.D. Works, which stands for
Medicaid for
Employees with
Disabilities. M.E.D. Works is
Indiana's health care program for working people with disabilities.
Now people with disabilities do not have to fear losing their
health care benefits under Medicaid or having a Medicaid spend-down
(spend-down is an out of pocket cost for members whose income or
assets are too high) just because they get a job, get a raise, or
work more hours.
M.E.D. Works would allow you to work without losing health care
coverage while also being able to save money for goals like
retirement, education or starting a new business. As a M.E.D. Works
member, you may pay a small monthly premium based on your income;
however, this is much smaller than the cost of a spend-down
payment.
Who Is Eligible?
To be eligible for M.E.D. Works, you must:
- be aged 16-64,
- meet certain income and assets guidelines (see below),
- be disabled according to Indiana's definition of disability,
and
- be working
Most M.E.D. Works members will be those already on Medicaid and
are often on Social Security Disability Income (SSDI). However, new
members who are working and disabled may still have M.E.D. Works as
an available option. Like all Medicaid programs, qualifying is
partially based on your income (money earned from a job and
unearned income such as a Social Security check), and you may pay a
Medicaid premium to receive coverage. The premiums are generally
much lower than the Medicaid disability spend-down amount. Please
note that M.E.D. Works is an individual only program. Your spouse
or children will not be eligible through you for coverage under
M.E.D. Works, even though they may be eligible for other Medicaid
services.
Financial Eligibility
To financially qualify for M.E.D. Works, you must not have
countable income above 350% of the Federal Poverty
Level (FPL). The Federal Poverty Level is determined by the Federal
government and changes on an annual basis. Below is a FPL table for
2013, that can be used as a guide. The only way to know for sure is
to apply.
|
The 2013 Poverty Guidelines
for the
48 Contiguous States and the District of Columbia
|
|
Persons in
family
|
Poverty
guideline
|
|
1
|
$11,490
|
|
2
|
$15,510
|
|
3
|
$19,530
|
|
4
|
$23,550
|
|
5
|
$27,570
|
|
6
|
$31,590
|
|
7
|
$35,610
|
|
8
|
$39,630
|
|
For families with more than 8 persons, add $4,020 for each
additional person.
|
There are certain types of income that are not included when
deciding if you are eligible for M.E.D. Works, examples of these
include;
- tax refunds,
- grants or scholarships allowed by federal law,
- Impairment Related Work Expenses (IRWE's), and
- income of your spouse or parents
In addition to income, your assets are also part of your
eligibility determination.
Certain assets do not count when deciding if you are eligible
for M.E.D. Works. These include:
- a car (if you use it to drive to work or medical
appointments),
- a home (if it is where you live),
- burial spaces,
- retirement savings held by you or, if you are married, your
spouse.
Medical Eligibility
In Indiana, Medicaid has its own eligibility criteria for
disability determination. This criteria differs from the Social
Security Administration's eligibility determination. In Indiana,
the definition of disability is a physical or mental impairment
verifiable by a physician that is expected to last 12 or more
months or result in death.
M.E.D. Works Services
M.E.D. Works offers the same services to its members with
disabilities as those in regular Medicaid. This means if you are
already a member of Medicaid because of your disability, but would
like to start working, your benefits under M.E.D. Works will be the
same as they are now.
M.E.D. Works Savings for Independence and
Self-Sufficiency
Another benefit that is available to M.E.D. Works participants
is called the Savings for Independence and Self Sufficiency
account. It is a special account for members who have extra money
to set aside to save for purchasing goods or services that increase
their ability to find or retain a job and make them more
independent.
Members can put up to $20,000 in the approved accounts.
Before the accounts are approved, a member must explain what
he or she will be using the money for and how it helps him or her
to improve his or her employability or independence. Each request
is based on an individual's unique situation, and goods or services
to be purchased must meet some of the criteria listed below:
- Your savings will be used to buy something that is necessary
for you to keep or increase your employment.
- You must explain what will be purchased and give an expected
date that you will purchase the item.
- Your goal must be something that you can achieve in a
reasonable amount of time.
- Your account cannot be used for personal recreation.
If you are interested in completing an application for an
Independence and Self-Sufficiency Account for M.E.D.Works members,
contact your local Division of
Family Resources.