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 you may call
(317) 234-2129.
