Learn More about Montana’s MWD Program
To be eligible for the Medicaid for Workers with Disabilities program, an individual must:
- Meet all non-financial eligibility criteria for Medicaid
- Currently be considered disabled by Social Security Act criteria, or would be considered disabled if not for current work activities
- Be age 16 or older
- Be employed (including self-employment) full or part time (i.e., are subject to FICA taxes)
- Be within resource limitations of the MWD program
- Have monthly countable family income at or below 250% of the Federal Poverty Level (FPL)
- Not be residing in a residential medical institution
- Pay a monthly cost share fee based on income of the worker(s) with disabilities only
To be eligible for the MWD program, your countable family income can not exceed 250% of the Federal Poverty Level (FPL).
2017 Monthly Income Limits:
*These amounts are “countable income,” not gross income.
If eligibility is determined, MWD benefits will only be issued after the Department receives and processes any cost-sharing payments that may be due.
What is “countable income” and how is it calculated?
If you just have Employment (earned) income:
(Gross wages – $85) / 2 = Countable Income
If you have both earned income and unearned (i.e. SSI, SSDI, etc.) income:
(Gross wages – $65) / 2
(Unearned income – $20)
Be aware that the “Financial Responsibility of Relatives” does apply to determining income for eligibility purposes and some income of financially responsible relatives may be considered deemable to the individual applying for benefits; spouses are responsible for spouses and parents/step-parents are responsible for minor children. The Office of Public Assistance will be able to assist you in determining how much, if any, of a responsible relative’s income may be deemable to you when you apply for the MWD program.
In addition to the general income exclusions that are used to determine your countable income, you may also qualify for other additional income exclusions, known as Income Related Work Expenses (IRWE), Blind Work Expenses (BWE), or others. For a full description of what IRWE’s and BWE’s are, along with more information about other income exclusions or employment supports and Social Security, please visit the Social Security Administration’s Red Book website or visit with a benefits specialist to determine how working will affect you.
- Individual — $15,000
- Couple — $30,000
Be aware that the “Financial Responsibility of Relatives” does apply to resources as well and some resources of financially responsible relatives may be considered deemable to the individual applying for benefits; spouses are responsible for spouses and parents/step-parents are responsible for minor children. The Office of Public Assistance will be able to assist you in determining how much, if any, of a responsible relative’s resources may be deemable to you when you apply for the MWD program.
What items count as resources?
A resource can be cash or something that can be converted to cash. Some examples are:
- Bank accounts
- Savings, checking, Certificate of Deposit, other investments
- One primary vehicle is allowed per household, additional vehicles are considered resources
- Motor Homes
- Motorcycles, etc.
- Land you do not live on
- Plus others
What items are excluded as resources?
- Household goods and personal effects
- Medical devices and adaptive equipment
- Certain life insurance policies
- A person’s home
- One automobile per household
- Some burial funds, burial spaces and life insurance assigned to funeral provider
- Student financial assistance received under Title IV of Higher Ed. Act or Bureau of Indian Affairs
- Some Individual Development Accounts (IDAs). To find out more about IDAs, including IDA programs in your area, you can visit Montana Bridge to Benefits IDA website.
- Some Trusts
Note: Retirement accounts owned by the worker with disabilities are excluded resources that do not count against the resource limit for the MWD program only.
Cost share fees are based on the net countable income (not gross income) of the worker with disabilities. If a qualifying worker with disabilities is married to a person who is not also a qualifying worker with disabilities, only the net countable income of the worker with disabilities will be used in determining monthly cost-share payments. If both spouses are qualifying workers with disabilities, the fee will be based on their combined net countable income.
Note: Enrolled members of federally-recognized tribes who provide verification of their current tribal enrollment are exempt from cost share fees.
Cost share fees for the MWD program are divided up into four income brackets as follows:
|% of FPL||Income (2017)||Monthly Payment|
|$0.01 to $1,005.00||$35|
|Up to 150%
|$1,005.01 to $1508.00||$67|
|Up to 200%
|$1,508.01 to $2,010.00||$100|
|Up to 250%
|$2,010.01 to $2,513.00||$135|
Note: this table only shows the Federal Poverty Level (FPL) amounts for a household size of one. The percent of FPL used to determine the cost share fee is the percentage of poverty for the household size equal to the number of workers with disabilities who qualify for MWD. If the worker with disabilities is married to an individual who is either not disabled or not working, the percent of poverty is based only on the FPL for one person, not two. The FPL for two is only used when determining cost share if both spouses qualify for MWD.
The monthly FPL amounts for a household of two are as follows:
- 100% FPL = $1,354.00
- 150% FPL = $2,030.00
- 200% FPL = $2,707.00
- 250% FPL = $3,384.00
Now that you know a little bit more about the Medicaid for Workers with Disabilities program, to apply for the program or to see if you qualify you have the following options:
- You can contact your local Office of Public Assistance;
- Or, you can apply online using the Department of Public Health and Human Services online application.
If you are currently working and enrolled in the Medicaid for Workers with Disabilities program and, for whatever reason, your employment ends, you will no longer qualify for the MWD program in any month in which you have not worked.
States no longer have the option of allowing for a grace period to keep people enrolled in Medicaid through the MWD program for temporary breaks in employment. If your employment ends and you are still in need of Medicaid coverage for months in which you are not employed, you will need to qualify for Medicaid through a different Medicaid eligibility category such as the Medically Needy eligibility category. Some things to keep in mind if this happens are:
- When MWD eligibility ends and other Medicaid programs are considered, the lower resource limits of the other programs will apply to eligibility: typically $2,000 for an individual and $3,000 for a couple;
- Retirement accounts that were considered excluded resources under the MWD program may no longer be considered excluded under other Medicaid eligibility categories; and
- You might not qualify for other Medicaid eligibility categories without first incurring a spend down.
While the Medicaid for Workers with Disabilities program allows qualifying workers with disabilities to continue receiving Medicaid coverage while working, other benefits can still be impacted by increased income from working wages.
If you receive benefits such as Low-Income Energy Assistance (LIEAP), food stamps (SNAP), or housing/rental assistance (Section 8, Public Housing, etc.), be aware that the amount of any assistance you receive will be reduced by an increase to your income because of your ability to pay more of these costs on your own. Likewise, if your income lowers you may be eligible for an increase in the amount of these types benefits you may receive.
Be sure to report any changes in your income to the appropriate agency to ensure the amount of benefits you receive is accurate and to avoid an over-payment, which you may end up having to pay back, or being terminated from a program because you didn’t report your income.