Medicaid Insurance for Workers with Disabilities (MIWD)
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Medicaid Insurance for Workers with Disabilities (MIWD), referred to by some as Nebraska's Medicaid Buy-In, is intended to allow people with disabilities who are competitively employed and who, because of wages would lose their benefits, to purchase Medicaid like private insurance.
Many people with disabilities want to work but worry that doing so could jeopardize their vital health and long term care coverage. MIWD offers people with disabilities who are working or interested in working the opportunity to keep their Medicaid coverage while on the job. Benefits include the same as those available through Nebraska Medicaid; the opportunity to earn more without the risk of losing health care benefits and support services; higher income eligibility; increased personal and financial independence; and Personal Assistance Services (PAS) at the workplace.
Your local DHHS Medicaid Eligibility Worker can provide you with eligibility and enrollment information *or you can contact a Work Incentives Specialist with Easter Seals Nebraska to help you with your benefits and answer questions. Contact Easter Seals Nebraska at 1-800-471-6425.
*The Nebraska Department of Health and Human Services has offices serving each of Nebraska's 93 counties. Contact information for each office, as well as other offices that provide DHHS-related services, can be found at the Nebraska Department of Health and Human Services website.
What are the Social Security disability thresholds for 2011?
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Through Nebraska’s Medicaid Insurance for Workers with Disabilities, people with disabilities can:
- Earn more save more and keep their health care coverage.
- Medicaid provides qualifying individuals a broad range of medical/health services that employer health insurance may not cover (e.g., pre-existing conditions or personal assistance services.
- The MIWD allows qualifying people with disabilities whose income levels are too high for them to receive SSI, to purchase Medicaid coverage much like one would purchase any health insurance policy.
- 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:
- The individual must qualify for Medicaid except for income (Share of Cost);
- Be determined disabled by Social Security or State Review Team;
- Have income within guidelines using a 2 part test.
- Only Medicaid workers determine eligibility for MIWD.
- Easter Seals does a benefit analysis with individuals to help them make employment decisions.
- Social Security determines if an individual qualifies for any trial work period time if gross earnings are $700 or more per month.
Nebraska's Medicaid Buy-In Coverage (MIWD)
Nebraska uses a two-step process for eligibility determination, as required by the BBA. We first compare an individual’s unearned income to the Federal Benefit Rate of $674 per month. (All unearned income is disregarded while the individual is in a trial work period.) If the individual qualifies based on unearned income, then total family income must be considered. If the total family income falls below 250% of the Federal Poverty Level (FPL), the individual is eligible for assistance under MIWD. If the individual’s income is between 200% and 250% FPL, a graduated premium is paid by the individual not to exceed 7.5% of earned income. A detailed description of the two-step process follows below:
Procedures for Medicaid Insurance for Workers with Disabilities (MIWD) Test A Income Steps
Test B Income Steps
TRIAL WORK PERIOD Social Security Disability Insurance (SSDI) Trial Work Periods are as follows: Trial Work Period: This is a period of nine months, which are not necessarily consecutive, during which an SSDI client earns more than $700 a month. The SSDI client’s benefits are not affected by the earnings during this nine-month period. Cessation Month: This is the month in which SSA determines that the SSDI client’s earnings are “substantial”, i.e., over the $980 Substantial Gainful Activity (SGA) level and benefits are to cease. This is the tenth month following the nine-month Trial Work Period. Grace Months: These are the two months (months 11 and 12) following the cessation month for which SSDI benefits may be paid even though the client has earnings in excess of the SGA level. Extended Period of Eligibility: If an SSDI client is medically disabled and continues to work, his/her benefits can be reinstated anytime during the 36 months following the nine-month Trial Work Period. Clients will receive their full SSDI benefit any month that their earnings fall below $980. SSDI benefits will continue any of these 36 months that the client does not earn $980. These 36 months are consecutive. All of the above are considered Trial Work Periods for Test A, i.e., disregarding earned income and unearned income contingent upon a Trial Work Period. We consider SSDI’s Trial Work Period (nine months), Cessation Month (one month), Grace Months (two months) and Extended Period of Eligibility (36 months) all Trial Work Period months and disregard SSDI unearned income in Test A. In determining which month of the Trial Work Period the client is in or if s/he is in a Trial Work Period, the worker should contact the Social Security Administration. 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 procedure is for SRT determination. State Review Team Referral Process WHO:
WHAT:
SRT will make a decision on the disability and send a DM-5R to the worker to take appropriate action. |
Useful Resources:
Report to the Health and Human Services Committee and the Medicaid Reform Council
Recommendations for Medicaid Insurance for Workers with Disabilities (MIWD) coverage.
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
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.
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