Medicaid Insurance for Workers with Disabilities (MIWD)

Medicaid Insurance for Workers with Disabilities (MIWD), referred to by some as Nebraska's Medicaid Buy-In, is intended to allow people who are competitively employed and who, because of wages would lose their benefits, to purchase Medicaid like private insurance. The program is administered by Health & Human Services and was implemented in July of 1999.

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 Benefits Specialist with Easter Seals Nebraska to help you with your benefits and answer questions. Contact Easter Seals Nebraska at 1-800-471-6425.

MIWD brochure

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, Workers 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 + ½ disregarded)
  5. Total the countable income for the individual or couple; if
    Greater than the single or couple FBR ($603-$904) = Fail Eligibility
    1. Less than or equal to the single or couple FBR ($603-$904) = Pass and go to Test B

Test B Income Steps

  1. Calculate the countable earned income. Give the $65 + ½ 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 = $1,634, 2=$2,202] 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.

Frequently Asked Questions

What does MIWD stand for?
MIWD stands for Medicaid Insurance for Workers with Disabilities.

What is Medicaid?
Medicaid is an DHHS administered program designed to pay medical bills for low-income persons.

What is the difference between Medicaid and Medicare?
Medicaid eligibility is based primarily on financial needs and is administered on a state-by-state basis. Medicare is not based on financial need, but is instead linked to the receiving of Social Security benefits based on being age 65 or older or having a disability. The federal government administers this program.

What is the Social Security Disability Insurance (SSDI) program?
Social Security Disability Insurance is wage replacement income for individuals who have paid FICA taxes that meet Social Security's rules for disability. SSDI is financed with Social Security taxes paid by workers, employers and self-employed persons. SSDI provides a variety of benefits to family members when a primary wage earner becomes disabled or dies. SSDI benefits are payable to disabled workers, widows, widowers and children or adults disabled since childhood who are otherwise eligible.

What are the Social Security disability thresholds for 2006?
For Substantial Gainful Activity (SGA), they are:

  • Non-blind: $860 per month
  • Blind: $1,450 per month
  • For Trial Work Period (TWP), the threshold is $620 per month.

Nebraska Health and Human Services System

The Health and Human Services System 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 Health and Human Services System website.

Working with Disability

These documents from Mathematical Policy Research, Inc., document the earnings of Medicaid Buy-In participants in 2004 and explain how the Medicaid Buy-In Program fits into other federal efforts to expand access to health insurance and enhance employment opportunities for adults with disabilities.