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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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MA for Employed Persons with Disabilities (MA-EPD)

Page posted: 10/01/03

Page reviewed: 2/08/13

Page updated 2/08/13

Legal Authority

Ticket to Work and Work Incentives Improvement Act, P.L. 106-170, Minn. Stat. §256B.057, subd. 9

Definition

Medical Assistance for Employed Persons with Disabilities (MA-EPD): Work incentive program that promotes competitive employment and economic self-sufficiency of people with disabilities by assuring continued access to Medical Assistance.

Eligibility

MA-EPD allows working people with disabilities to qualify for MA under higher income and asset limits than standard MA. To be eligible, a person must:

• Be certified disabled by either the Social Security Administration or the State Medical Review Team prior to age 65.

• Be employed

• Have Medicare and Social Security taxes withheld or paid from earned income

• Have average monthly earnings of more than $65 (there is no upper income limit)

• Live in Minnesota

• Meet the asset limit

• Pay a premium

• Pay an unearned income obligation if required

Asset limit

Assets are things a person owns. The asset limit for MA-EPD is $20,000. There is no asset limit for pregnant women and children ages 16-21. Some assets that do not count towards the limit are:

• Burial fund (up to $1,500)

• Burial space items

• Car used to get to work or medical appointments

• Home the person lives in

• Household goods, clothing and personal items

• Medical expense accounts set up through an employer

• Qualified retirement accounts

• Spouse’s assets

Premiums

People must pay a monthly premium. A person must pay a minimum of $35 or pay a premium based on a sliding fee scale, whichever is greater. MA-EPD bases the premium on a person’s income and household size. There is no maximum income limit or maximum premium amount.

Unearned income obligation

In addition to the monthly premium, people who have unearned income such as Social Security Disability must pay one-half of one percent (1/2%) of their unearned income. To calculate the monthly unearned income obligation, multiply the total unearned income amount by .005. The unearned income obligation is included in monthly premium billing.

MA-EPD Eligibility Renewal

The local county human services agency reviews MA-EPD income and asset eligibility every six months.

Process

The county collects initial premiums. DHS bills and collects ongoing premiums.

DHS has an on-line tool to estimate a person’s monthly premium at MA-EPD monthly premium estimator. This tool provides only an estimate. For an actual, accurate premium, local county human services must review the application and determine the final amount.

Covered Services

MA-EPD covers the same services as standard Medical Assistance (MA). Prevailing community standards or customary practice and usage must determine the service to:

• Be appropriate and effective for the person’s medical needs

• Be medically necessary

• Be the most cost effective health service available for the person’s medical needs

• Meet quality and timeliness standards

Click here for a list of MA covered services.

Process

The county collects initial premiums. DHS bills and collects ongoing premiums.

DHS has an on-line tool to estimate a person’s monthly premium at MA-EPD monthly premium estimator. This tool provides only an estimate. For an actual, accurate premium, local county human services must review the application and determine the final amount.

Application

To apply, people complete the Minnesota Health Care Programs Application (DHS-3417) and return it and all required verifications to their local county human services agency.

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© 2017 Minnesota Department of Human Services Updated: 2/8/13 8:01 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 2/8/13 8:01 AM