Medicaid Policy
Medicaid Policy
Previous Policy (314-7 rewritten into 462 as of June 1, 2020)
Some individuals with disabilities who are working may qualify for the MWI program. (Refer to 314 for the eligibility criteria.) They may owe a premium to receive coverage.
1. As an incentive to encourage disabled individuals to work, the MWI program charges a premium when the person's countable income (or the couple's countable income) is over 100% of the FPL. In most situations, a premium would be lower than a spenddown.
2. The MWI premium structure has three tiers based on the level of countable income of the individual or couple. The individual's or the couple's countable income is compared to certain percentages of the FPL to determine the amount of the premium.
3. To determine the countable income for the MWI premium calculation, follow the income policies for Aged, Blind and Disabled Medicaid in 443. This income test includes deemed income from an ineligible spouse (427-2), or from ineligible parents of a minor child. (427-3)
4. When the countable income exceeds 100% of the FPL, the individual is subject to the MWI premium calculation (462-1).
5. Individuals must pay their premiums with cash (check, money order, credit card, debit card).