What is MEPD?
Medicaid for Employed People with Disabilities (MEPD) is a Medicaid coverage group to allow persons with disabilities to work and continue to have access to medical assistance.
What are the eligibility requirements for MEPD?
People who are disabled and have earned income can get Medicaid when the person:
- Is under age 65.
- Is still considered to be disabled based on SSI medical criteria for disability.
- Has earned income from employment or self-employment.
- Meets general SSI-related Medicaid eligibility requirements.
- Is not eligible for any other Medicaid coverage group other than QMB, SLMB, or Medically Needy.
- Have resources less than $12,000 for an individual and $13,000 for a couple.
- Has net family income less than 250% of the federal poverty level.
- Pays any premium due for the monthly eligibility.
| 2024 MEPD Monthly Income Limits | |
|---|---|
| Household/ Family Size | Limit (Net countable income less than 250%) |
| 1 | $3,138 |
| 2 | $4,259 |
| 3 | $5,380 |
| 4 | $6,500 |
| 5 | $7,621 |
| 6 | $8,742 |
| 7 | $9,863 |
| 8 | $10,984 |
| 9 | $12,105 |
| 10 | $13,225 |
| 11 | $14,346 |
| 12 | $15,467 |
| 13 | $16,588 |
| 14 | $17,709 |
What services are covered by MEPD?
- MEPD members receive all Iowa Medicaid benefits.
- Prescription services are included for members who do not have Medicare. For those members enrolled with Medicare as well as MEPD, prescription coverage will go through a Medicare Part D plan.
- MEPD will pay for your Medicare Premiums.
Do I have to pay a monthly premium for MEPD?
If your monthly gross income is over 150% of the federal poverty level, you will have to pay a premium. You will get a Notice of Decision telling you the amount of your monthly premium.
To find your monthly gross income, add your gross earned income and your gross unearned income together. The premium you will have to pay will be on the same line.
| MEPD Premium Amounts Effective August 1, 2024* | ||
|---|---|---|
| If the monthly gross income of the disabled person is: | Federal Poverty Level (FPL): | The monthly premium payment is: |
| $1,883 or less | At or below 150% | $0 |
| More than: | More than: | |
| $1,883 | 150% | $41 |
| $2,071 | 165% | $57 |
| $2,259 | 180% | $68 |
| $2,510 | 200% | $79 |
| $2,824 | 225% | $93 |
| $3,138 | 250% | $108 |
| $3,765 | 300% | $136 |
| $4,393 | 350% | $165 |
| $5,020 | 400% | $194 |
| $5,648 | 450% | $224 |
| $6,903 | 550% | $280 |
| $8,158 | 650% | $338 |
| $9,413 | 750% | $397 |
| $10,668 | 850% | $469 |
| $12,550 | 1000% | $563 |
| $14,433 | 1150% | $660 |
| $16,315 | 1300% | $760 |
| $18,574 and above | 1480% | $879 |
| MEPD Premium Amounts Effective August 1, 2020* | ||
|---|---|---|
| If the monthly gross income of the disabled person is: | Federal Poverty Level (FPL): | The monthly premium payment is: |
| $1,699 or less | At or below 150% | $0 |
| More than: | More than: | |
| $1,699 | 150% | $34 |
| $1,869 | 165% | $47 |
| $2,039 | 180% | $56 |
| $2,265 | 200% | $66 |
| $2,549 | 225% | $77 |
| $2,832 | 250% | $89 |
| $3,398 | 300% | $112 |
| $3,964 | 350% | $137 |
| $4,530 | 400% | $161 |
| $5,097 | 450% | $186 |
| $6,229 | 550% | $232 |
| $7,362 | 650% | $280 |
| $8,494 | 750% | $329 |
| $9,627 | 850% | $389 |
| $11,325 | 1000% | $467 |
| $13,024 | 1150% | $547 |
| $14,723 | 1300% | $631 |
| $16,761 and above | 1480% | $729 |
Note: Your monthly premium will not go up during the 12-month enrollment period. The premium may go down if you report that your income has decreased.
When are premiums due?
A billing statement will be sent to you that shows the month a premium is due. To get Medicaid on the first day of next month, premiums should be received by Iowa HHS by the last day of the month. Your MEPD will be canceled if you do not pay the premium by the 14th of the month.
What happens if I am late paying my premium?
If you do not pay the premium by the due date, your MEPD will be cancelled. If you make a premium payment late:
- MEPD can be reinstated if your ongoing month’s payment is received by the last day of the month it is due.
- MEPD coverage can be reopened if the payment is late but is received in the month after the month which it was due
- If your payment is more than three months late, it will not be accepted and you will not be able to get Medicaid for that month. It is very important that you make your premium payment on time or early if possible.
How do I pay my premium?
A postage-paid envelope is included with your bill. If you lose your MEPD Billing Statement, you can call your local Iowa HHS office to get a new one mailed to you. If you lose your envelope, you may mail your payment to the address below:
Iowa Medicaid MEPD Premium
Treasurer State of Iowa
PO Box 78003
Minneapolis, MN 55480-2800
Please write your name and your member ID number on the check or money order. If this information is not included, your payment may not be credited to the right account.
Where can I get medical care?
Most MEPD members receive coverage from the Iowa Health Link program. This program gives you health coverage through a Managed Care Organization (MCO) that you get to choose.
Some Medicaid members receive Medicaid coverage through the Medicaid Fee-for-Service (FFS) program. These members may see any provider who agrees to be paid by Iowa Medicaid. You can contact Iowa Medicaid Member Services for more information on Fee-for-Service and available providers.
Will I have a co-payment?
It is possible that you may have a copayment. If you receive your Medicaid coverage through a Managed Care Organization, your member handbook will inform you of possible copayments for certain services or treatments. If you receive your coverage through the Medicaid Fee-for-Service program, the following is a breakdown of your co-payment amounts:
| Co-Payment Amount | Service |
|---|---|
| $1.00 per visit | Services from a podiatrist, chiropractor and physical therapy. |
| $2.00 per visit | Ambulance services, audiology services, hearing aid dealer services, medical equipment, optical services, prosthetic devices, psychology services and rehabilitation services. |
| $3.00 per visit | Dental services, hearing aides, physician office visits and lab services |
How do I find out if I qualify for MEPD?
To find out if you can get MEPD, you must fill out a Medicaid application and send it to your local Department of Health and Human Services (HHS) office. The application may be mailed, faxed or delivered to the HHS office. For further information on how to apply, please go to the "Apply for Services" web page.