Health and Employment Counseling (HEC) Program - Consumer Guide

What's in this Consumer Guide?

What is the Health and Employment Counseling Program (HEC)?

The Health and Employment Counseling Program (HEC) is a 9-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 the Medicaid Purchase Plan, 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.

When do I apply for the Medicaid Purchase Plan, before or after enrollment in HEC?
Contact a county economic support worker before you start the HEC process. The economic support worker can help you apply and see whether you meet the eligibility requirements for MAPP. Also, if you don't have a disability determination from the Disability Determination Bureau (which you must have to participate in MAPP), the economic support worker will get your application started. Look in the government pages in your telephone book or call 1-866-278-6440 to find the economic support or Health & Human Services agency near you.

What is the definition of "working"?
The economic support agency processing your Medicaid Purchase Plan (MAPP) application will confirm that you are meeting the work requirement for MAPP.There is no minimum number of hours required to meet the work requirement, so employment can be part-time, self-employment, employment at a sheltered workshop, or other.  Contact your economic support worker for more information about the MAPP eligibility requirements.

HEC Overview:
You enroll in the HEC "program" by developing and completing an Employment Plan.This plan should include your employment goals, and how you plan to achieve those goals within a 9-month time frame.

The Employment Plan will be screened by a HEC Manager at the Department of  Health Services (DHS). If your plan is approved, you will be enrolled in HEC. It is your responsibility to use the resources you've identified in the Employment Plan to achieve your employment goals. At the end of 9 months, you must be employed to continue to participate in the Medicaid Purchase Plan.

You may develop the Employment Plan on your own or with someone's assistance, such as a caseworker, benefit specialist or vocational counselor. The Employment Plan includes sections on benefits counseling, employment barriers assessment and community resources. After completing your plan, submit it to DHS final approval.

If your application is approved, you will receive a letter confirming your enrollment in the HEC program. You must give a copy of this letter to the economic support worker as verification of your HEC enrollment. If you have met the other eligibility criteria, you may complete your enrollment in the Medicaid Purchase Plan.

The Employment Plan:
The Employment Plan is a four-page tool to help you organize your employment goals. You must have a completed, approved Employment Plan to enroll in the Health and Employment Counseling program.

If you don't have a blank form you may contact your economic support or 1-866-278-6440.

Use this form to think about your career goals, and identify the things that may stand in your way. There are five sections to the Employment Plan:

  • Section 1 – Career Planning
  • Section 2 – Employment Barriers
  • Section 3 – Benefits Counseling
  • Section 4 – Networking with Community Resources
  • Section 5 – Create a Plan.

Fill out each section as completely as you can, then take the completed plan to your HEC Manager for approval.

Note: If you already have a recent employment plan from an agency,such as the Division of Vocational Rehabilitation or a Community Service Provider, you don't need to complete the entire HEC Employment Plan. Only fill in the areas of the HEC employment plan that your other employment document does not cover. Then, attach a copy of your other plan.

Section 1- Career Planning

To start off your employment plan, think about your career goals:

  • What do you want to be doing in 9 months?
  • What kind of job do you want?
  • What skills do you have?
  • What skills do you need to be successful at the job you have identified?

You may also want to think about long-term career goals.

Remember, to continue in the Medicaid Purchase Plan, you need to be working within 9 months of being approved for HEC.

Section 2 - Employment Barriers
If you had an offer from your dream job, what would prevent you from going to work tomorrow? The things that come to mind are your "employment barriers".

Some examples of employment barriers may be; a limited work history, reliable transportation, skills training, or assistive technology. Write your employment barriers down in question 4.

Think about what you need to do to remove your barriers. Write down your steps to overcome them.

Section 3 - Benefits Counseling
If you go to work and increase your earnings, it will affect the benefits that you receive. The Health and Employment Counseling Program encourages you to have a benefits discussion with a work incentives benefits specialist before you go to work.

For additional information about your benefits, contact the following resources:

Social Security Administration: (800)-772-1213 or 

  • You may request a "Redbook" for information on Social Security work incentives.

Local County Health & Human Services or Job Center: 

  • Information on Food Stamps or Medical Assistance.

Local Housing Authority:

  • Information on Section 8 or Public Housing.

Benefits Tips . . .  Some things to think about:

  • What kinds of benefits do you receive?
  • How will each of those benefits change with increased earnings? And what work incentives might be available?
  • How will the Medicaid Purchase Plan features affect your other benefits? For example, higher assets in MAPP may decrease or eliminate other benefits.

Section 4 - Networking With Community Resources

Use this section of the Employment Plan to write down what resources you are working with or plan to contact to pursue your employment goals. Identify a contact name, agency/role and phone number for all agencies with which you are working. Your Regional Screener may also be able to help you with possible resources in your community.

Section 5 - Create a Plan
In this section, you will create your plan for achieving employment and overcoming any barriers you identify. For example, if you need to learn more about your chosen job goal, you may plan to meet with someone who works in a job like the one you want. Or you may need to take a class, or figure out how to get to and from work. Write down the steps you need to complete, and when you plan to do them in this section. This is your plan of action to help you find and keep a job.

Next-to-last Step
Now, take your completed Employment Plan to the HEC Manager at DHS.  If you don't know how to find a screener in your area call 1-866-278-6440.

If your Employment Plan Application is screened successfully, you will receive a letter of approval from the HEC Manager located at the Wisconsin Department of Health Services.

If it's not approved, you will receive an explanation of why it was not approved. You can appeal this decision through the Medicaid appeals process if you disagree or you may also submit a revised plan to the HEC Manager.

Last Step
After you receive an approval letter from the Department of Health Services you have 9 months to put your Employment Plan into action and find a job.  To complete your enrollment in MAPP and begin receiving Medicaid, take this letter to your economic support worker. If you meet all of the MAPP eligibility requirements, you may participate. Good luck!

Don't forget! There is no limit to the number of months/years that you can participate in the Medicaid Purchase Plan, as long as you meet all the eligibility criteria.

Last Revised: December 29, 2016