Frequently Asked Questions

For help with Medicaid for Employed People with Disabilities (MEPD):

• Call Medicaid at 1-800-338-8366 or look on the Medicaid website.
• Visit or call your local Health and Human Services (HHS) office.
• Talk to an Iowa health insurance navigator. You can call them at 1-877-474-6284 or make an appointment online.
• If you have a disability, talk to a benefits planner to learn more about health programs for people with disabilities.

There are different ways to apply for Medicaid for Employed People with Disabilities (MEPD):

• Online using the Iowa HHS Benefits Portal. The Iowa HHS Benefits Portal lets you apply for other programs, like the Supplemental Nutrition Assistance Program (SNAP) or the Family Investment Program (FIP), at the same time.
• In person at your local Health and Human Services (HHS) office.
• By filling out a paper application and bringing it in person to your local Health and Human Services (HHS) office or faxing or mailing it to the address listed on the form.

Note: If you get Supplemental Security Income (SSI) or used to and now are on SSI 1619(b), you automatically get Medicaid coverage. You do not need to apply for Medicaid and do not have to pay a premium.

To qualify for Medicaid for Employed People with Disabilities (MEPD), you must:

• Be under 65 years old
• Have a disability
  • Note: For MEPD, Social Security’s disability rules related to earned income do not apply.
• Be working and have income from your job or self-employment
• Be a U.S. citizen or meet specific noncitizen requirements
• Have $12,000 or less in resources ($13,000 if you're married), and
• Have family countable income at or below 250% of the Federal Poverty Guidelines (FPG) for your family size.
  • If you're single, that's $3,260 or less per month; for a family of four, that's $6,698 or less per month of countable family income.

To see if someone qualifies for MEPD, MEPD counts their family's money the same way that SSI does: almost all of the family members' unearned income is counted, but less than half of their earned income is counted. For example, this means that if you live alone and don't have any unearned income, you could make as much as $6,610 per month at work and still qualify!

You may have to pay a monthly premium that is based on your own income, not your family's combined income. If your gross income is more than $1,956, you will have to pay a premium for MEPD coverage. The higher your income, the more your premium will be. See how much your MEPD premium might be.

Medicaid is a public health coverage program. There are different ways to qualify for Medicaid, depending on things like your age, income, resources, and whether you have a disability. One of the ways to get Medicaid coverage is through Medicaid for Employed People with Disabilities (MEPD).

To qualify for MEPD:

• You must be working and earning money.
• You must have a disability that meets Social Security's disability rules (except for the rules related to work).
• You must meet certain income and resource limits. These limits are higher than the income and resource limits for other Medicaid programs.
• You may have to pay a monthly premium based on your income.

People who don't qualify for MEPD may be able to get Medicaid a different way:

• If you have low income, you may qualify for the Iowa Health and Wellness Plan (IHAWP).
• If you get Supplemental Security Income (SSI) or qualify for SSI’s 1619(b) rule, you automatically get Medicaid.
• If you are eligible for a Medicaid Waiver program, which helps people with disabilities who need extra care to be able to live in their own home, you can get Medicaid.

In most cases, it does not matter how you qualify for Medicaid, because the actual medical coverage you get from Medicaid will be the same. Generally speaking, the big difference is that people with disabilities may get extra ways to qualify and if you have a disability and start working, you can earn more while still getting Medicaid coverage.

DB101 has information about different ways to get Medicaid:

• The Iowa Health and Wellness Plan (IHAWP) article explains the most common way to qualify, which does not require you to have a disability.
• The disability-based Medicaid article explains other ways you might get Medicaid if you have a disability, including getting Medicaid automatically through Supplemental Security Income (SSI) benefits.
• The Medicaid for Employed People with Disabilities (MEPD) article explains a way that people with disabilities who work can get Medicaid coverage by paying a premium, even if their income is higher than the usual Medicaid income limits.

If your gross income is more than $1,956 per month, you have to pay a monthly premium for Medicaid for Employed People with Disabilities (MEPD) coverage. The more income you have, the higher your premium will be.

Note: This is different than the countable income calculation that is used to see if you qualify for MEPD, which includes your family members' incomes. The income of the rest of your family does not affect your premium amount.

No, countable income is not the same as how much you make. When public programs look at your income to figure out if you should qualify, they don’t always count all of your income. What they do count is called “countable income.” This benefits you, because it means that you might have more income than the income limit for a program, but still qualify.

When Medicaid for Employed People with Disabilities (MEPD) reviews your family's income to see if you qualify, only about half of your and your family members' earned income (money you get from work you do) is counted. For example, if you live alone, make $4,000 per month at a job, and have no other income, that’s only $1,957.50 in countable monthly income.

Use the tool below to figure out your family's countable income. If it is at or below 250% of the Federal Poverty Guidelines (FPG) for your family size, you may qualify for MEPD.

Your MEPD Family Countable Income:

Your family size:	123456789101112
Your Family's Monthly Earned Income	$
Your Family's Monthly Unearned Income	$
	$1,305
	$20
	$65
Your Family's Monthly Countable Income
	$15,650
	$5,500
250% of Federal Poverty Guidelines
Your Countable Income as a Percent of FPG
(Over MEPD limit)	0.00
(Under MEPD limit)	0.00

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Yes, Medicaid for Employed People with Disabilities (MEPD) pays for the same services that standard Medicaid pays for, including doctor visits, medical equipment, and home care services. See what services are covered under MEPD.

If you are eligible for both Medicaid for Employed People with Disabilities (MEPD) and Medicare, it is helpful to have both at the same time, because MEPD will help pay for things that Medicare doesn't pay for and will help pay your Part B premium.

In addition to MEPD, if your income is low enough, you may also qualify for a Medicare Savings Program to help pay other Part B expenses (and your Part A premium, if you have one), and the Part D Low Income Subsidy, to help pay for your prescription drugs.

Contact your local Iowa SHIIP and SMP counselor if you have questions about how your Medicaid and Medicare benefits work together. To learn more, read DB101’s Medicare article.