Skip To: Main content|Subnavigation|
Minnesota Department of Human Services Community-Based Services Manual (CBSM)
DHS Home CountyLink Home Manuals Home Bulletins
Advanced Search
Show/Hide Table of Contents  

Medical Assistance for Employed Persons with Disabilities (MA-EPD)

Page posted: 10/1/03

Page reviewed: 10/11/18

Page updated: 10/11/18

Legal authority

Minn. Stat. §256B.057, subd. 9, Public Law 105-33

Definition

Medical Assistance for Employed Persons with Disabilities (MA-EPD): Minnesota Health Care Program (MHCP) that allows people with disabilities to qualify for or keep their Medical Assistance (MA) while working.

How it can help

Fear of losing Medical Assistance (MA) prevents many people with disabilities from working. With MA-EPD, people can work, earn, save money and still keep their MA.

The MA-EPD program:

  • • Has no upper income limit, so people can earn any amount of money and stay on the program
  • • Has a higher asset limit than standard MA, so people can save money while they work
  • • Has premiums that are less than MA spenddowns, so people with spenddowns have lower health care costs when they work and switch to MA-EPD
  • • Is not for people who receive Supplemental Security Income (SSI) or lose their SSI solely because of earnings (these people can keep their free MA through 1619(b); they do not need MA-EPD unless they lose 1619(b)).
  • Support planning

    When lead agency staff develop support plans for people they support, they must understand the connection between MA-EPD and other services/programs.

    Employment

    People who receive employment exploration or employment development services through a waiver can become eligible for MA-EPD when they start working.

    People who receive employment support services through a waiver are usually eligible for MA-EPD.

    MA-EPD also can help people who are interested in transitioning from sheltered employment to competitive, integrated employment keep their MA during that transition.

    Housing

    MA-EPD can help people who want to move out of a group housing setting into their own home keep their MA during that transition. Working and saving money on health care costs (if they have a spenddown) can help make their housing budget work.

    Eligibility

    To be eligible, a person must meet all of the following criteria:

    1. Be certified disabled by either the Social Security Administration or the State Medical Review Team before age 65 (see DHS – Determining if you have a disability and DHS –FAQs about the State Medical Review Team)

    2. Be employed and:

  • • Have Medicare and Social Security taxes withheld or paid from earned income
  • • Have average monthly earnings of more than $65 (Note: MA-EPD does not have an upper income limit)
  • 3. Live in Minnesota

    4. Meet the $20,000 asset limit (see asset limit section)

    5. Pay a monthly premium (see premiums section)

    6. Pay an unearned income obligation, if required (see unearned income obligation section).

    For more information, see DHS – MA-EPD.

    Covered services

    MA-EPD covers the same services as regular MA. For a list of covered services, see the “benefits” tab on DHS – MA-EPD.

    Asset limit

    Assets are things a person owns. The asset limit for MA-EPD is $20,000. There is no asset limit for people younger than age 21.

    The following assets do not count toward the limit:

  • • ABLE accounts
  • • Burial fund (up to $1,500)
  • • Burial space items
  • • Car used to get to work or medical appointments
  • • Home in which the person lives
  • • Household goods, clothing and personal items
  • • Medical expense accounts set up through an employer (e.g., health savings account)
  • • Qualified retirement accounts
  • • Spouse’s assets.
  • Premiums

    People pay a monthly premium based on their income and household size. The lead agency calculates premiums based on a minimum of $35 or a sliding fee scale amount, whichever is greater. There is no maximum premium amount.

    The Disability Benefits 101 (DB101) MA-EPD premium tool helps estimate a person’s monthly premium. DHS encourages lead agencies to use this tool and share it with people who are considering MA-EPD.

    Note: Premiums are waived for people who have a verified American Indian or Alaska Native status.

    Unearned income obligation

    In addition to the monthly premium, people who have unearned income (e.g., Social Security Disability) must pay one-half of one percent (1/2 percent) of their unearned income.

    The unearned income obligation is included in monthly premium billing. The DB101 MA-EPD premium tool includes this additional cost in its calculation.

    Application

    To apply, a person must complete the MHCP Application for Certain Populations, DHS-3876 (PDF) and return it with all required verifications to his/her lead agency.

    If a person is unable to complete the full application, he/she can set the date MA-EPD coverage starts by completing Request to Apply for Minnesota Health Care Programs, DHS-3417B (PDF) and returning it to his/her lead agency.

    Eligibility and renewal process

    The lead agency eligibility worker uses policies and procedures defined in MHCP Eligibility Policy Manual – Medical assistance for employed persons with disabilities to:

  • • Review the person’s application
  • • Determine the premium amount
  • • Collect the initial premium
  • • Review income and asset information to re-determine eligibility every six months.
  • DHS bills and collects ongoing premiums.

    Note: Program HH pays all MA-EPD premiums for people who are eligible for both programs.

    Benefits planning

    When people are considering work (or changing their work), they need to know the effect it will have on their benefits. A person can receive benefits planning as part of waiver employment exploration, development and support services. Lead agencies also can reference and share the following resources with people who have questions:

  • DB101 – Benefits videos and success stories – includes a series of short videos (less than five minutes each) to help people learn about how work and benefits go together
  • Getting Ahead with Minnesota Benefits (Video) – talks about MA-EPD and other state benefits and how those benefits support work.
  • The Disability Hub MN also has trained options counselors who can help people understand the effects of work on their benefits. For more information, see Disability Hub MN – Work or call 1-866-333-2466.

    Additional resources

    DB101 – MA-EPD: The basics
    DB101 – Public Benefits: A Bridge for People with Disabilities (Video)

    Disability Hub MN
    (or call 866-333-2466)
    MA-EPD brochure, DHS-2087L (PDF)

    MHCP Eligibility Policy Manual – Medical assistance for employed persons with disabilities

    Rate/Report this pageReport/Rate this page

    © 2018 Minnesota Department of Human Services Updated: 10/11/18 9:26 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 10/11/18 9:26 AM