477 Neb. Admin. Code, ch. 24, § 003

Current through September 17, 2024

Section 477-24-003 - MEDICAID INSURANCE FOR WORKERS WITH DISABILITIES (MIWD)

003.01 Medicaid Insurance for Workers with Disabilities

Working individuals who meet the necessary disability criteria, have income within income guidelines, and are working, are eligible for Medicaid. After application of income disregards, individuals with income less than 200 percent of the Federal Poverty Level (FPL) are eligible for Medicaid with no premium; individuals with income of 200 through 249 percent of the FPL are eligible for Medicaid with a monthly premium payment. See Appendix 477-000-046 for procedures.

003.02 Eligibility Requirements

In order to receive Medicaid, the individual(s) must:

1. Qualify for Medicaid except for income;

2. Not be eligible for AABD/MA, but may be a share of cost;

3. Meet Social Security or State Review Team definition of disability;

4. Be working;

5. Using a two-part income test have income within income guidelines;

6. Meet Medicaid resource limits; and

7. Pay a premium, if required.

003.03 Disability Determination

Individuals who are not receiving a Social Security Disability payment must be determined disabled by the State Review Team. Receipt of an SSDI payment meets the disability requirement.

003.04 Income Determination

The income calculation is a two-step process. The income of the disabled individual and his/her spouse must be considered. See Appendix 477-000-009 for calculation procedures.

003.05 Premium Payment

If the individual is determined eligible for Medicaid with a premium, s/he must pay the full premium no later than the 21st day of the month following the month for which the payment is designated.

477 Neb. Admin. Code, ch. 24, § 003