People with disabilities who work may get coverage under a program called Medical Assistance for Employed Persons with Disabilities (MA-EPD). MA-EPD may also reimburse the cost of Medicare Part B premiums for people with income below 200 percent of the Federal Poverty Guidelines (FPG). People with income or assets above the MA limits may qualify for MA-EPD. People must pay a premium for MA-EPD coverage.
To be eligible for MA-EPD, you must:
Be certified disabled by either the Social Security Administration or the State Medical Review Team
Be employed and have required taxes withheld or paid from earned income
Have monthly earnings of more than $65
Meet the asset limit
Pay a premium
Pay an unearned income obligation if required
What is the income limit?
There is no income limit for MA-EPD.
What is the asset limit?
The asset limit for MA-EPD is $20,000. Some assets that do not count toward the limit are:
The home you live in
One vehicle under certain conditions
Household goods, clothing and personal items
Medical expense accounts set up through an employer
Burial space items or burial funds (up to $1,500)
Retirement accounts may not be counted the same as other assets
What does MA-EPD cost?
Most people pay a monthly premium for MA-EPD. Premiums are based on your income and household size. The amount is set by a sliding-fee scale or a minimum of $35, whichever is greater. There is no maximum premium amount for MA-EPD.
American Indian enrollees are not required to pay premiums.
Unearned income obligation
If you have unearned income like Social Security Disability, you must pay one-half of one percent of your unearned income each month. To calculate the unearned income obligation, multiply your total unearned income by .005. This cost is in addition to the monthly premium.
You may also have copays for some services.
Can I have other insurance and still get MA-EPD?
Yes, you may have private, group or employer-subsidized health insurance in addition to MA-EPD. Many services that are not covered by other insurance policies may be paid for by MA-EPD.
If you have other health insurance, that insurance must be used first, following the rules of that primary plan (e.g., must use network providers, obtain referral or authorization as required, etc.). Then services not covered may be paid through MA-EPD.
When does coverage start?
You must pay your premium or give proof of your American Indian status before your coverage starts. Coverage may go back three months from the date we get your application. Call your county or tribal office if you have questions about when coverage can start.
What if I lose my job or cannot work because of a medical condition?
If you are enrolled in MA-EPD and you lose your job through no fault of your own (you did not quit or get fired), you may stay on MA-EPD for up to four months while looking for another job. If you do not have a job after four months, you cannot be on MA-EPD.
If you become unable to work because of a medical condition, you may stay on MA-EPD for up to four months. You must have a written, signed doctor's statement that says you are expected to return to work within four months. If you cannot return to work within four months, you cannot be on MA-EPD.
How does working affect other benefits?
For information on how working may affect other benefits, such as Social Security Disability Insurance, Medicare, Social Security Income, Minnesota Supplemental Aid, private disability insurance, subsidized housing, Supplemental Nutrition Assistance Program (SNAP) and veteran benefits, go to Disability Benefits 101.
MA-EPD pays for the same services as regular MA, including:
Alcohol and drug treatment
Dental care (limited for non-pregnant adults)
Emergency room (ER) care
Family planning services
Hospital services (inpatient and outpatient)
Immunizations and vaccines
Lab and X-ray
Licensed birth center services
Medical equipment and supplies
Medical transportation (access, ambulance and special)
Mental health care
Nursing homes and ICF-DD facilities
Personal care assistance
Physical, occupational and speech therapy
Prescriptions (except enrollees who also have Medicare) and Medication Therapy Management
Some services, such as prescription drugs, non-preventive care visits and eyeglasses may have copays. See MA coverage for more details. In certain circumstances, MA-EPD may cover Medicare or other health insurance premiums, copays and deductibles.