In operation since 2002, M.E.D. Works (Medicaid for Employees with Disabilities) offers insurance coverage to disabled individuals who wish to return to work. In Indiana, this allows Medicaid beneficiaries to continue working without the fear of losing their public health benefits, or having to participate in a Medicaid spend-down program due to the fact that they have become employed, received a raise, or work longer hours. M.E.D. Works is offered for a small monthly premium based on a person’s income, which is much less than a spend-down payment. This allows individuals to save on their medical expenses in order to save money for other purposes, such as retirement or education.
Like all Medicaid programs, to qualify you must meet certain income and asset guidelines, have a job, and be disabled according to the state of Indiana’s definition of disability. Eligible residents must also live in Indiana and be between ages 16 and 64. The majority of M.E.D. Works members will already be beneficiaries of Medicaid and Social Security Disability Income (SSDI), yet new members who are working and disabled may be able to join, as well. M.E.D. Works is an individual-only program, and does not cover dependent spouses or children.
Those who qualify for M.E.D. Works must have an income that does not exceed 350 percent of the Federal Poverty Level (FPL). Some types of income are not included when considering an applicant for the program, including tax refunds, grants or scholarships allowed by federal law, Impairment Related Work Expenses, and the income of a person’s spouse or parents. Assets are also counted, which includes a car (if used to drive to work or medical appointments), a home (if it is your residence), burial spaces, or retirement savings held by you or your spouse, if married. Below are the maximum incomes a person eligible for M.E.D. Works may earn to be considered for the program.
Family of 1: $3,258 monthly, $39,095 annually
Family of 2: $4,413 monthly, $52,955 annually
Family of 3: $5,568 monthly, $66,815 annually
Family of 4: $6,723 monthly, $80,675 annually
Family of 5: $7,878 monthly, $94,535 annually
Family of 6: $9,033 monthly $108,395 annually
Family of 7: $10,188 monthly, $122,255 annually
Family of 8: $11,343 monthly, $136,115 annually
For families and households over 8 persons, add $3,960 for each additional person.
The Medicaid program in Indiana has a separate definition of disability from the Social Security Administration’s eligibility criteria. Indiana determines disability as a physical or mental impairment verifiable by a physician that is expected to last at least a year or more, or result in death.
M.E.D. Works offers the same coverage as traditional Medicaid. Therefore, if you are already a Medicaid member due to your disability and you would like to return to work, M.E.D. Works will not in any way change the coverage you received previously. Benefits include the same array of preventive care, disease management, physician services, hospital care, emergency care, surgery, medical equipment and supplies, therapies, and all other types of services Indiana Medicaid covers.
Savings for Independence and Self-Sufficiency
An additional benefit when enrolled in M.E.D. Works, the Savings for independence and Self-Sufficiency account allows members to create a savings for important future goals. This account lets M.E.D. Works participants to set aside funds for purchasing goods or services that make them more independent or able to find or retain a job. Each account may hold up to $20,000, and prior to establishing the account, the member using it must specify how they plan to use the funds, and how that will increase their ability to take care of themselves and stay employed.
As every individual is different, members will be evaluated separately according to their goals and life circumstances. The services or goods to be obtained with this account must meet a few of the following requirements in order to be approved:
- Savings will be used to buy something necessary for you to keep or increase your employment.
- Explain what will be purchased and provide an expected date you will make the purchase.
- The goal must be something attainable within a realistic amount of time.
- The account cannot be used for personal recreation.
Members of M.E.D. Works are required to pay a monthly premium for their coverage. This amount varies based on your income level, and if you are married or single. The numbers for 2009 were the most recent premiums available, though they vary each year depending on a corresponding percentage of a person’s income.
How to Apply
To enroll in M.E.D. Works or to find out if you qualify, contact your local Division of Family Resources office. If you are not already enrolled in regular Medicaid, you must complete an application online, in person, by mail, or by phone. Applications are also available at your local DFR office.
Contact Indiana Medicaid
1. Indiana Medicaid. “M.E.D. Works”. http://member.indianamedicaid.com/programs–benefits/medicaid-programs/med-works.aspx.