This is really confusing. Where can I get help?

Where can I sign up?

The only way you can apply for Medical Assistance for Employed Persons with Disabilities (MA-EPD) is by filling out the Minnesota Health Care Programs Application for Certain Populations and taking it or mailing it to your local county human services agency. You cannot sign up online.

Note: You should only use this application if you think you might qualify for MA-EPD. If you are not sure whether you qualify for MA-EPD, Chat with a Hub expert.

I have been getting MA-EPD. Will my MA-EPD change?

No. You can continue to get the MA-EPD benefits you currently receive. If your income, assets, or family situation change, you may qualify for a different health coverage program.

Who is eligible for MA-EPD?

To qualify for MA-EPD, you must be a Minnesota resident who is working or self-employed, paying Social Security and Medicare taxes, and earning more than $65 per month. (If you are self-employed, your earnings are your self-employment income minus business expenses and self-employment taxes.)

You must be certified disabled by the Social Security Administration (SSA) or the State Medical Review Team (SMRT) and you must have less than $20,000 in assets.

You must not be eligible for standard Medical Assistance (MA) without a spenddown, and you must not be living in a long-term care facility for more than 30 days.

Is MA-EPD coverage free?

No. You must pay a monthly premium based on your income and household size. As your income goes up, or as your household size goes down, your premium will go up. There is a $35 minimum premium for the program. For an estimate of what your MA-EPD premium would be, use the MA-EPD Estimator.

Does MA-EPD cover the same services as standard MA?

Yes. MA-EPD pays for the same services that standard MA pays for, including doctor visits, medical equipment, and Personal Care Assistant (PCA) services. See the complete list of services covered by MA-EPD.

What is the difference between MA, MA with a spenddown, and MA-EPD?

MA: You only pay small copayments for medical services. You may qualify for income-based MA or disability-based MA, depending on your situation. You also qualify for MA if you qualify for SSI’s 1619(b) provision.

MA with a spenddown: You "spend down" your income by paying the first part of your medical costs. The amount you are responsible to pay before disability-based MA starts paying is the difference between your countable income and the "income standard." The income standard is 81% of the Federal Poverty Guidelines (FPG) ($843 for an individual, $1,141 for a family of two). Note: Usually, if you qualify, MA-EPD will be a better option than MA with a spenddown.

Medical Assistance for Employed Persons with Disabilities (MA-EPD): You pay small copayments and a monthly premium based on your income and household size. Generally, if you are certified disabled by the Social Security Administration or the State Medical Review Team (SMRT) and are working you will qualify for MA-EPD.

DB101's MA overview compares these different ways of qualifying for MA.

Am I better off with MA-EPD or standard MA with a spenddown?

Almost always, MA-EPD is a better deal, because you will end up paying less than you would with MA with a spenddown, while getting the exact same services.

Example: If your total countable monthly earnings are $2,000, your MA-EPD premium would be about $99 per month, whereas your monthly spenddown would be about $291.

If you have a lot of old, unpaid medical bills, you should talk to your county human services agency to find out if you would be better off with MA-EPD or MA with a spenddown until the bills are paid.

For estimates on MA-EPD premiums and MA monthly spenddown amounts, use the MA-EPD Estimator.

What is the MA-EPD income limit?

You must work and earn at least $65 a month to qualify for MA-EPD. But there is no upper income limit. This is one of the great advantages of MA-EPD: you could earn tens of thousands of dollars per month and still qualify for the program.

The more you earn, the higher your monthly premium will be. And there is a $20,000 asset limit.

Does MA-EPD have an asset limit?

Yes. MA-EPD has a $20,000 asset limit, but a lot of things don’t count toward it, including the home you live in, the car you drive to work, retirement accounts, personal items such as furniture and clothes, medical expense accounts set up by an employer, and your spouse's assets.

Things like saving accounts, certificates of deposit, boats, recreational vehicles, and second cars do count toward the asset limit. However, if your disability began before you turned 26, you can open an ABLE account where you can save up to $15,000 each year and not have it counted by MA-EPD. Leran more about ABLE accounts.

See the complete list of things that MA-EPD does not count as assets. Chat with a Hub expert for more information.

I have private health coverage. Is there any reason I should consider MA-EPD?

Yes. There are a couple of reasons why you might want both private coverage and MA-EPD:

  • MA-EPD may cover services that your private coverage doesn’t (e.g., transportation, home care, medical equipment).
  • If the county determines that your private coverage is cost-effective, MA-EPD will actually pay your private premiums, copayments and deductibles. If this is the case and your MA-EPD premium is less than your private premium, there is no reason not to keep both forms of coverage. You’d pay less and get more comprehensive coverage.

I have Medicare. Why should I consider MA-EPD?

It depends on your situation and the services you need. In some situations, it makes sense to enroll in both.

MA-EPD covers a lot of services that Medicare doesn’t and you might reduce the amount you have to pay in coinsurance, deductibles, and copayments by enrolling in both programs as opposed to just Medicare.

If you are eligible for Medicare, you have to keep it in order to enroll in MA-EPD. The state will pay your Medicare Part B premium for you if your total income is less than 200% of the Federal Poverty Guidelines ($2,082 per month for an individual).

Does it matter how I qualify for MA?

In most cases, no. The actual medical coverage you get from MA will basically be the same, no matter how you qualified. Generally speaking, the big difference is that people with disabilities have extra ways to qualify and if you have a disability and start working, you can earn more while still getting MA coverage.

DB101 has four articles about different ways to get MA:

  • DB101's MA overview compares the different ways of qualifying.
  • The income-based MA article explains the most common way to qualify, which does not require you to have a disability.
  • The disability-based MA explains a common way that people with disabilities who have low incomes can qualify.
  • The MA-EPD article explains a way that people with disabilities can get MA coverage by paying a premium, no matter how high their income.

If you are not sure how you qualified for MA, you can ask your local county human services agency.