Medical Assistance Purchase Plan
The Medicaid Purchase Plan (MAPP) extends access to Medicaid benefits to individuals with disabilities who are working, or are interested in working. MAPP differs from other Medicaid programs in a variety of ways:
- Individuals may qualify with higher income and asset levels;
- Depending on an individual’s income, a premium payment may be required;
- The definition of disability for the MAPP program excludes the first step of the Social Security Administration’s disability determination process (Is the individual earning over the SSA substantial gainful activity level, which is $940 per month in 2008). This means that earnings are not considered in the finding of disability.
- Individuals are able to work without fear of losing their health care coverage based solely on their ability to work.
Administration:
Like other Medicaid programs, MAPP is administered by the Wisconsin Department of Health Services (DHS).
Information about MAPP can be found on the DHS website, http://dhs.wisconsin.gov/medicaid1/recpubs/factsheets/phc10071.htm, and Medicaid Eligibility Handbook (MEHB) Section 5.12.
The MEHB is available online at
http://www.emhandbooks.wi.gov/meh-ebd
Health and Employment Counseling:
The Health & Employment Counseling (HEC) program is a nine-month pre-employment program for people with disabilities who want to enroll in the Medicaid Purchase Plan (MAPP), but who are not yet employed.
Through MAPP, people with disabilities who are working or enrolled in HEC may buy their Medicaid coverage by paying a monthly premium, based on income. Individuals with low income may not have to pay a premium.
HEC allows individuals who are not currently employed to enroll in MAPP. The HEC program has three components:
- benefit counseling;
- identification of barriers to employment; and
- networking and community resources.
HEC participants must first file a MAPP application at the County Economic Support Office. The employment plan is reviewed by the Department of Health and Family Services. Approval/denial letters are then sent to the applicant. The applicant must then present the approval letter to the County Economic Support Office.
If a HEC plan is approved, MAPP eligibility will be granted for a period of nine months. If the individual is not employed at the end of nine months, MAPP eligibility will end. A three-month extension of the nine-month HEC period will be granted if requested within the first 7 months and it’s determined that the individual is likely to be employed during the extended period. Applicants may only access MAPP through the HEC program twice in any five year period. More about HEC...
HEC regional screeners are available to assist with the development of an employment plan. Find a HEC Regional Screener. The DHS website also includes a Consumer Guide to the HEC program.
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