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Video: Apple Health for Workers with Disabilities (HWD)

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Introduction

If you have a disability and you are working, you may be able to buy Medicaid coverage through Apple Health for Workers with Disabilities (HWD).

Cathy Murahashi (00:00):
Hi, I’m Cathy Murahashi, and I am the parent of two young adults with disabilities. I’m very excited about the changes to the Healthcare for Workers with Disabilities program. I was actively involved in advocating for these changes. We now have more opportunities for people with disabilities to work more, save more, and work longer. I know benefits are confusing and difficult to navigate, and as a parent, I am always worried about my son or daughter losing their services. The changes to this program are real and you can access it now. I want you to know that I am signing one of my children up for HWD as we speak. If you are worried about how it will work, or not sure how will impact your benefits or services, contact your case manager to have them help you see how your son or daughter would be impacted. The good news is that there are many people signing up now and enjoying the improved quality of life from being able to make more and save more money. This video will give you more information about how Healthcare for Workers with Disabilities works.

Susan Harrell (01:16):
Hi, I’m Susan.

Scott Leonard (01:18):
And I’m Scott.

Susan Harrell (01:19):
And we’re here to talk about another benefit in our series on How Public Benefits Support Employment. Today we’ll be talking about Apple Health for Workers with Disabilities, or HWD.

Scott Leonard (01:35):
And I’m excited today to be talking about HWD. I think it’s such a great program, and I’m excited to drill down into it and give you information to help you understand that all the benefits.

Susan Harrell (01:45):
So the reason that we are so excited to talk about this is that this is one of those Medicaid programs that actually offers the opportunity for people to build income and wealth, and maintain eligibility for Medicaid. One of the greatest fears that people have when they have a disability is their loss of Medicaid, otherwise known as Apple Health in Washington State, and that’s because Medicaid offers so much to people with disabilities, particularly those who need support in order to be employed and to live in their communities. And that fear can really keep people tethered to the benefits. And the benefits that have low income and low resource limits mean that people really have to suppress their opportunities to earn and save over time, in order to maintain those essential services, but Medicaid buy-in programs like HWD, which we’re talking about today, offer additional options for people. And this will allow individuals to access Medicaid by paying a premium, and therefore, it allows some to have higher and higher resource limits.

Scott Leonard (03:02):
So Washington State’s Buy-In program is titled Apple Health for Workers with Disabilities. We call it HWD, and it offers all of these things: no income limit, no resource limit, no upper age limit, there’s some additional options that we’ll talk about, and then the premiums that you pay the cost no more than 7.5% of the total monthly income. And they can be less than that amount.

Susan Harrell (03:29):
So really that’s $75 maximum for every $1,000 that somebody has in total income.

Scott Leonard (03:37):
That’s right.

Susan Harrell (03:37):
That’s a pretty reasonable healthcare option.

Scott Leonard (03:40):
Absolutely. Especially when you consider how much Medicaid may be paying for. You know, people understand that Medicaid may pay for doctor’s bills or prescriptions, but it can pay for so much more. It can pay for employment supports. It can pay for in-home personal care. There’s a lot of things it pays for.

Susan Harrell (03:56):
Yes, it’s pretty exciting. And you know, an additional note, these changes around no income limit, no upper age limit, and some of the additional options or changes that have been made and implemented for January 2020 forward. So these are very exciting for people who knew and have accessed Healthcare for Workers with Disabilities in the past, because it expands the opportunities even further. As we said, HWD has no income or resource limit at this point, January, 2020 on. This offers an additional work incentive to individuals because it allows people to earn or save as much money as they want without an issue with Medicaid. It also allows people with high unearned income to be ABLE to remain eligible for Medicaid. And this has been a struggle for a lot of people when they get a very high Social Security check, or some other source of income that isn’t considered to be earned income, it has really been a struggle for folks to maintain eligibility for Medicaid. But if they are working, they’re on HWD and they have high unearned income, this is no longer going to be a problem when it comes to remaining eligible. And also people don’t have to worry about raises or promotions, even if they’re accessing Medicaid as a person with a disability through a different pathway, they could always move over into HWD if they need to maintain Medicaid. So they can say yes to promotions, they can say yes to raises. And these features are really unique to HWD. And just keep in mind that while income may not be counted for eligibility, it won’t be, there is no no income limit, and again, there’s no resource limit, income is used to determine the monthly premium amount.

Scott Leonard (05:56):
So one of the changes also in 2020 is that HWD will no longer have an upper age limit. So it’s available to people age 16 and older. And now in 2020, it allows people who are aged 65 and older to pursue or continue their work and saving efforts. And that’s a really big deal. It used to be that people who are on HWD could be on that program up to age 65, but this now takes away that age limit.

Susan Harrell (06:24):
It’s very exciting because many of us are intending to work well beyond the age of 65, so it’s great that this is an option for people with disabilities as well.

Scott Leonard (06:35):
HWD is also not providing a lasting asset protection. What this means is that an individual who is exiting the HWD program can protect earnings held in a separate account, and those funds will be excluded as a resource for other Medicaid assistance programs. Now, to be excluded, the income in this account must contain earnings only, which means that money can not be co-mingled with funds from other types of income, such as an inheritance or gifts. Though overall, this is a really great feature of HWD because it means people don’t have to struggle to figure out how to protect assets upon leaving the program. Now, there are other ways to protect dollars as counting as a resource, such as ABLE and Special Needs Trusts, but this offers just another opportunity for people to not have to be so concerned in the middle of other changes. Now let’s take a look at the eligibility considerations. So HWD is for working individuals is Healthcare for Workers with Disabilities, correct? So people must be working at the time of eligibility and they must be working at the time of eligibility anniversary date. So when a person first applies and needs, to be working and then each year on their anniversary date, they need to be working at that time. So if someone were to lose their job and then become employed again, as long as they’re working on that anniversary date, they can stay in the HWD program. Now there are provisions about what qualifies as employment. They have different rules for example, around self-employment and when you work for an employer, but generally speaking, when a person is paying taxes that qualifies as employment. Now, people must qualify under the Social Security disability definition with some exceptions in regards to Substantial Gainful Activity or SGA, as we call it, and medical improvement. Please check out these resources.

Speaker 5 (08:30):
[Acoustic guitar plays soflly].

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