Medicaid: Qualified Disabled and Working Individual Program
The Qualified Disabled and Working Individual (QDWI) Program helps you pay for Medicare Part A premiums if you have a disability and are working.
Who is eligible?
You may be eligible for the QDWI Program if you:
- Have a disability and are working.
- Are entitled to Medicare Part A benefits.
- Have countable assets at or below the program limit.
- If it’s just you, you cannot have more than $4,000 in assets.
- You and your spouse cannot have more than $6,000 in assets.
- Have countable monthly income less than 200% of the federal poverty level after certain credits are applied.
- If it’s just you, you cannot make more than $2,430 each month.
- You and your spouse cannot make more than $3,286.66 each month.
- Are not enrolled in Medicaid.
Asset and income limits are based on federal guidelines, which may change each year.
How do I apply?
You can apply:
- By phone.
- In person.
- By mail.
Learn how to apply.
How do payments work?
If you are eligible for the QDWI Program, Medicaid will start paying your Medicare Part A premiums up to three months before the date of your application.
When that happens, your Social Security payment will go up because the premiums, deductibles, and coinsurance for Medicare Part A will no longer be deducted. You’ll get a notice from the Social Security Administration. They’ll give you a refund for any payments you made after the date you were enrolled in the QDWI Program.
Your Social Security payment may not change for one to three months, though. That’s because it takes time for Medicaid, Medicare, and the Social Security Administration to adjust payments. This means your payments may be higher than usual for a short period of time.
Example: If your application was approved in April for the months of April, March, and February, you’re enrolled in the QDWI Program in May. Your Social Security payment may not change until July. You’ll get a refund for premiums you paid for February, March, April, May, and June.
Who do I contact for help?
You can call the Wisconsin Medigap Helpline at 800-242-1060. You can also contact your local aging and disability resource center or a benefit specialist.