Example

Melanie’s Story

Melanie is 35 years old and has cerebral palsy. She hasn’t been able to work for the past six months due to her disability and been living on the $850 in Social Security Disability Insurance (SSDI) benefits she gets every month. She gets Medicaid through the Iowa Health and Wellness Plan (IHAWP), because she has too much in resources to qualify for Supplemental Security Income (SSI).

She’s been feeling better recently and wants to go back to work. So she talks to some friends and passes her resume around. Soon enough, a former coworker offers her a part-time job at his new start-up company. Unfortunately, the job does not come with health insurance and she’d be earning too much money to keep her Medicaid. She really wants to take this job, but she cannot risk going without health insurance. Between her prescription drugs, physical therapy, and Personal Assistance Services (PAS), her total medical cost is several thousand dollars per month.

She talks about the problem with her personal assistant, Samantha, who mentions Medicaid for Employed People with Disabilities (MEPD).

"It’s designed for people like you," Samantha says. "You can go back to work and earn more money than the regular Medicaid income limit, while still keeping your Medicaid health coverage."

“But what about my savings? Can I keep them?” Melanie asks.

“I think so,” says Samantha, “but you should talk to your Medicaid caseworker to find out more.”

Melanie calls her caseworker to ask about MEPD. Her caseworker explains that with MEPD, Melanie can have up to $12,000 in resources. She can also have up to $3,260 in countable income each month.

"'Countable income' doesn't mean all of your income, though," her caseworker tells her, "so you could have even more income than that limit. Here's how it works: Almost all of your unearned income, like your $850 in SSDI, will be counted, but when you earn money at your new job, less than half of that income is counted. So in your case, you could make up to $4,925 a month at your job, still meet the countable income requirement, and still qualify for MEPD."

This is exciting news for Melanie! She can go back to work and not worry about losing her health coverage. MEPD pays for all the same services that her Medicaid coverage has been paying for. The only difference is that she may have to pay a monthly premium, depending on her income.

“Plus,” her caseworker tells her, “if your condition gets worse and you have to take some time off work, you won’t necessarily lose your coverage as long as you are an employee.”

“This all sounds great,” says Melanie. “So what do I do now?”

“Take that job,” says her caseworker, “and when you get your first paycheck, call me to report your earnings. Once you report the change in income, I'll be able to switch your coverage to MEPD."

Melanie is ecstatic. She’ll be able to go back to work, doing something she really enjoys. And she’ll be able to keep her health coverage for a reasonable monthly cost.