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Frequently Asked Questions

 

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MED Works

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Social Security Benefits and Work

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Q: What is MED Works?

A. During the 2001 Legislative Session, the Indiana General Assembly passed House Enrolled Act 1950 which mandated the creation of a new Medicaid program for persons with disabilities who are employed. MED Works - Medicaid for Employees with Disabilities, allows working individuals with incomes too high for regular Medicaid to be eligible for health coverage. MED Works members whose income is more than 150% of the federal poverty level will be charged a premium on a sliding-fee scale based on income. These individuals will receive the full-range of traditional Medicaid-covered services and will pay the same co-payments for certain services.

Q: Who is eligible for MED Works?

A. MED Works is available to people who are disabled, according to Indiana Medicaid standards, and who are working. Financial eligibility is based a formula for determining countable income. Countable income must not exceed $3034 (350% of the federal poverty level).

Q: How do I find out if I am eligible for MED Works?

A. Contact your local Division of Family Resources (DFR) office. If you are not already on Medicaid Disability, you must apply for Medicaid and meet the medical eligibility requirements.

Q: I only have a small part-time job, would I be eligible for MED Works?

A. Probably. There is no minimum work effort defined for this program. As long as your employment is verifiable through pay stubs, W-2, or self-employment records you will be considered employed and eligible for MED Works, provided that you meet all other eligibility criteria.

Q: I’m already on Medicaid Disability, if I go to work and get on the MED Works program, will my benefits change?

A. No. The Medicaid benefits for traditional Medicaid Disability are the same as for MED Works. MED Works is Medicaid.

Q: How much are the premiums?

A. Premiums are a sliding scale fee based on monthly gross income. For people with an income of under 150% of the federal poverty level , there is no premium. Premiums range from $48-$187 for a single person and $65-$254 for a married person.

MED Works Premiums

Q: How often do I pay my premiums?

A. Premiums are paid monthly.

Q: Where do I send my payments?

A. You will receive a bill with a payment stub that will provide the address to send payments. You may also call the MED Works Payment Line at 866-273-5897 for the address and information about your payments.

Q: I have private health insurance through my job, should I drop that?

A. No. If you pay to participate in private health insurance, continue to do so. Your MED Works premium will be adjusted by the amount you pay each month for private health insurance. Medicaid should always be the payer of last resort and will pick up where the private insurance leaves off.

Q: What about my spend-down?

A. Participants on MED Works do not have spend-downs. They have premiums instead. In general, the premiums for MED Works are much lower than spend-down would be.

Q: What happens if I lose my job?

A. You may retain your MED Works coverage for 12 months following the involuntary termination of employment if you notify your caseworker within 60 days and continue to meet certain criteria to maintain a connection to the workforce.

Q: How can I get more information about this program?

A. Information can be found on the MED Works web page, or contact your local Division of Family Resource claims representative.

The Disability Benefits and Work website was funded by the Medicaid Infrastructure Grant (CFDA # 93.768)

This site is intended for informational purposes only. Individual situations vary widely and must be evaluated on an individual basis by Division of Family Resources eligibility caseworkers, or Social Security Claims Representatives and/or Indiana Works-Community Works Incentive Coordinators. Links from this site are provided to help people research various topics and do not constitute endorsements by the State of Indiana or its partners.