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Wisconsin Medicaid Fact Sheet
Medicaid Purchase Plan
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What is Medicaid Purchase Plan?
The Medicaid Purchase Plan offers people with disabilities who are working
or interested in working the opportunity to buy health care coverage through
the Wisconsin Medicaid Program. Depending on an individual’s income, a
premium payment may be required for this health care coverage.
What are the eligibility requirements?
To qualify for the Medicaid Purchase Plan, the following requirements must
be met. The participant must:
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Be at least 18 years old.
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Reside in Wisconsin.
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Have individual countable assets of less than $15,000.
(Countable assets include savings, life insurance policies, stocks or
bonds. A home or one vehicle is not considered a countable asset.)
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Be determined to have a disability by the Department of
Health and Family Services’ Disability Determination Bureau.
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Be employed in a paid position or be enrolled in a
certified Health and Employment Counseling program.
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Have an adjusted family income of less than 250% of the
federal poverty level, based on your family size. Contact the
county/tribal social or human services department for additional
information.
What does the Medicaid Purchase Plan offer?
Under the Medicaid Purchase Plan, participants:
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Receive the same health benefits offered through the
Wisconsin Medicaid Program.
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May earn more income, than another group of Medicaid
recipients, without the risk of losing health care coverage.
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Are allowed increased personal and financial independence
through saving opportunities, known as Independence Accounts. An
Independence Account is any new financial account set up through a
financial institution, such as a bank or credit union, and registered with
a county/tribal human or social services department. Pre-existing
retirement and pension accounts may also be used as Independence Accounts
subject to similar contribution restrictions applicable for new accounts.
By setting up Independence Accounts, participants can save earnings above
the Medicaid Purchase Plan asset limit ($15,000) to buy
independence-related items (i.e., a home or vehicle) or services.
Is family coverage available under the Medicaid Purchase Plan?
No. Family coverage is not available under the Medicaid Purchase Plan.
What if health insurance is available through the participant’s
employer or spouse’s employer?
The Medicaid Purchase Plan may pay for insurance coverage for the
participant through the participant’s employer’s health plan if the
employer’s health plan would cost less than Medicaid. The participant will
pay a Medicaid Purchase Plan premium, and Wisconsin Medicaid will pay the
other cost-sharing expenses such as premiums, deductibles, and coinsurance of
the health insurance plan.
For More Information Call:
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Medicaid at 1-800-362-3002 (TTY and translation services
are available).
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The county/tribal social or human services department, W-2
agency, or Medicaid outstation site in your county.
Information provided in this document is general. To find
out more detailed information regarding the Medicaid Purchase Plan, please
contact your local county/tribal social or human service agency.
DHS is an equal opportunity employer and service provider.
If you have a disability and need to access this information in an alternate
format, or need it translated to another language, please contact (608)
266-3465 or (608) 266-2555 TTY. All translation services are free
of charge.
For civil rights questions call (608) 266-3465 or (608)
266-2555 TTY.
P-10071 (N.05/02)
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