Medicaid Insurance for Workers with Disabilities (MIWD) Eligibility

Many people with disabilities want to work, but they don’t because they fear they will lose their needed Medicaid benefits. Nebraska’s Medicaid Insurance for Workers with Disabilities (MIWD) offers a workable solution to this problem. It allows people with disabilities who are working or want to work the opportunity to buy their health care coverage.

Through Nebraska’s Medicaid Insurance for Workers with Disabilities, people can:

The MIWD program may be appropriate for disabled (AABD) clients who are working and would otherwise qualify for Medicaid but have a Share of Cost due to earnings. The MIWD program has a small client base state wide, but an awareness about the program is important. Some also refer to this program as Working Disabled.

Main MIWD program points to be aware of:

  1. The individual must qualify for Medicaid except for income (Share of Cost);
  2. Be determined disabled by Social Security of State Review Team;
  3. Have income within guidelines using a 2 part test.
  4. Only Medicaid workers determine eligibility for MIWD.
  5. Easter Seals does a benefit analysis with individuals to help them make employment decisions.
  6. Social Security determines if an individual qualifies for any trial work period time if gross earnings are $620 or more per month.

Useful Resources:

Independent Living Centers and Their Contact Information
Please contact an Independent Living Center in your area for more information.

Chapter 8 Regulations for Medicaid Insurance for Workers with Disabilities

Flow Chart for Medicaid Insurance for Workers with Disabilities - Share of Cost

One-Stop Career Centers Employment Systems
One-Stop Career Centers were created by the Workforce Investment Act of 1998 and are designed to serve as a streamlined delivery system for both businesses needing to hire workers and people seeking jobs, including people with disabilities.

Procedures for Working Disabled Medicaid Premium Payment:

Test A - Income Steps

  1. Disregard all the disabled individual's earned income.
  2. Disregard all the disabled individual's unearned income that is based on a trial work period.
    1. Social Security Disability payment is disregarded if he/she is in a trial work period. The worker must contact Social Security to verify the trial work period.
    2. VA Disability payment, Worker's Compensation payment , Civil Service disability, and private disability insurance must be verified with the source to determine if the receipt of the payment is based on that source's trial work period.
  3. Count all other unearned income for the disabled individual and spouse.
  4. Count the spouse's net earned income ($65 + 1/2 disregarded).
  5. Total the countable income for the individual or couple; if
    1. Greater than the single or couple FBR ($637 or $956) = Fail Eligibility
    2. Less than or equal to the single or couple FBR ($637 or $956) = Pass and go to Test B.

Test B - Income Steps

  1. Calculate the countable earned income. Give the $65 + 1/2 disregard to the individual or couple. [The disabled individual's earned income IS counted, unlike Test A.]
  2. Calculate all gross unearned income for the individual or couple. Only give the $20 general income disregard and the $10 interest/dividend disregard on ALL unearned income. [The disabled individual's unearned income that was disregarded in Test A is now counted.]
  3. Total all countable income for the individual or couple.
    1. If countable income is EQUAL to or GREATER than 250% of Federal Poverty Level for the household = FAIL eligibility for Working Disabled Medicaid Premium Payment (MIWD). Reject the case with a manual IM-8 unless the individual chooses a share of cost.
    2. If countable income is LESS than 200% of Federal Poverty Level for the household [101% through 199%] = PASS eligibility for Working Disabled Medicaid Premium PAYMENT. [200% FPL 1 = $1,734, 2=$2,334] The disabled individual would also be eligible for Medicare Part B buy-in.
    3. If countable income is 200% to 250% of Federal Poverty Level [200% through 249%] = PASS eligibility for Working Disabled Medicaid Premium Payment (MIWD) WITH A MONTHLY PREMIUM PAYMENT. [See chart] The disabled individual in NOT eligible for Medicare Part B buy-in.

Disability Determination
Individuals currently receiving a Social Security Disability payment (SSDI) will not need an additional disability determination. All other individuals considered for this new program must have a disability determination from the State Review Team (SRT). The following procedures is for SRT determination.