Medical Assistance for Employed Persons with Disabilities

2.3.5.2.1 Bases of Eligibility

In general, MA for Employed Persons with Disabilities (MA-EPD) follows the MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) non-financial eligibility policies. People must be certified disabled and use the disabled or blind basis of eligibility to enroll in MA-EPD. Disability or blindness must be certified by the Social Security Administration (SSA) or the State Medical Review Team (SMRT).

Changing Basis of Eligibility after Job Loss

When an MA-EPD enrollee stops working other than during a four-month job loss or four-month medical leave, or no longer meets the work requirements, their eligibility must be redetermined under another MA basis of eligibility. If the MA-EPD enrollee is redetermined eligible under an MA-ABD basis, the enrollee is eligible for MA-ABD with no asset limit for 12 consecutive months. Standard MA-ABD asset limits and policies apply after the 12 months. If during the12 consecutive months of no asset limit the enrollee loses MA-ABD eligibility for one month or more, the MA-ABD asset limit applies to all subsequent months and MA-ABD eligibility determinations.

Changing Basis of Eligibility after Age 65

Some MA-EPD income and asset rules continue to apply when redetermining basic MA eligibility for an enrollee, age 65 or older, who loses eligibility for MA-EPD for any reason and who was enrolled in MA-EPD during each of the 24 consecutive months before their 65th birthday.

When redetermining MA-ABD eligibility under these circumstances:

The income of a spouse is not deemed to the person
The assets of a spouse are not deemed to the person

MA-EPD enrollees who are redetermined eligible for MA for People Age 65 or Older will qualify for MA-ABD with no asset limit for up to 12 months, followed by MA-ABD eligibility with an asset limit of $20,000. This will apply to MA-EPD enrollees who:

become ineligible for MA-EPD at age 65 or older because they have stopped working or no longer meet work requirements, and
were enrolled in MA-EPD for the 24 consecutive months before turning age 65.

Asset limits still apply to Medicare Savings Programs. See 4.2.3.1 MSP Assets for more information.

Redetermination Under All Bases

Eligibility must be redetermined under all bases, including MA with a spenddown, when MA-EPD eligibility ends for any reason (for example, non-payment of a premium). MA-EPD eligibility and coverage is not continued while eligibility is being redetermined for any month in which a premium was not paid.

Legal Citations

Minnesota Statutes, section 256B.057