“The Medical Assistance for Workers with Disabilities (“MAWD”) Program”
By Crystal L. Welton, J.D., LL.M.
Obtaining eligibility for Medical Assistance (“MA”) can be a difficult and frustrating process for individuals with special needs. It can be especially tricky for individuals with special needs who have resources or a monthly income in excess of the resource and income limits for SSI-related MA and Healthy Horizons MA. To qualify for these programs, the applicant’s countable income must not exceed one hundred percent (100%) of the federal poverty level, which is $908.00 for 2011; the allowable resource limit is $2,000.00. For Pennsylvanians faced with this dilemma, another alternative is available, the Medical Assistance for Workers with Disabilities (“MAWD”) program.
The MAWD program is a public health insurance program available for individuals with disabilities who are between the ages of 16 and 64, who work and receive compensation for their work, and whose income and resources do not exceed the allowable limits. MAWD also requires that the applicant be a Pennsylvania resident who is a United States citizen or covered immigrant. Individuals eligible for MAWD receive full MA benefits by paying a monthly premium of five percent (5%) of their countable income.
To be eligible for MAWD, an applicant must meet the following requirements:
1. Be a Pennsylvania resident, who is a US citizen or covered immigrant;
2. Be between the ages of 16 and 64;
3. Be disabled according to the definition established by the Social Security Administration;
4. Work and receive compensation for that work;
5. Have countable income less than $2,269.00 per month (for 2011); and
6. Have countable resources less than $10,000.00 (for 2011).
One concern for individuals with special needs is that they are disabled according to Social Security Administration’s definition and unable to work. Well, the work requirement is not as daunting as it seems, and it is much lower than the Social Security standard of substantial gainful employment. While MAWD requires that the applicant work and receive compensation for that work, there is no minimum amount of work required. Accordingly as little as 1 hour per month can satisfy this requirement. An applicant can perform various types of work, including, but not limited to, babysitting, lawn/yardwork, pet-sitting, tutoring, making phone calls, administrative tasks, and/or providing transportation to another individual. When applying for MAWD, by using the PA 600 WD form, the applicant should provide proof of employment and compensation, which can be satisfied by providing a signed letter from the employer, which should include the work performed, the frequency of the work performed, the amount of compensation received, and the employer’s contact information.
MAWD’s income and resource limits are much higher than those generally allowed by other MA programs. Accordingly while MAWD requires that applicants work, receive compensation, and contribute 5% of their countable income as a monthly premium, this program is especially beneficial to individuals with special needs, who require health insurance due to their disability, are unable to qualify for other Medical Assistance programs due to excess income and/or resources, and are generally unable to pay for private health insurance.
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