Frequently Asked Questions
Q: If you live in Kansas and work in another state, can you enroll in Working Healthy?
A: Yes, residency is established based on where you live. You may work in another state as long as you live in Kansas.
Q: Can a consumer be enrolled in Working Healthy and be on a Home and Community Based Services (HCBS) Waiver?
A: No, a consumer must choose between Working Healthy or an HCBS Waiver.
Q: Can the Working Healthy program and/or Benefits Specialists help me find a job?
A: No, Working Healthy is the Medicaid coverage program for people who are working and cannot help individuals with job placement. Benefits Specialist can however direct you to programs that assist with finding jobs. For example, if you are looking for a job, consult Kansas Job Link or contact the One-Stop Workforce Development Center in your area.
Q: Is there a limit on the number of people who can enroll in Working Healthy?
A: No, Working Healthy does not have a limited enrollment, and therefore no waiting list.
Q: I know that I want to enroll in Working Healthy. Now what do I do?
A: An individual can enroll in a number of ways. If you already have an DCF eligibility worker, you can contact that person and ask to enroll. You can also contact the Benefits Specialist for your region, and request assistance in applying for the program. Or you may call your local DCF Office, and request an application. The application form is called an ES-3100.
If you want to have an improved understanding of how employment or increased income affects your present benefits, schedule a time to meet with a Benefits Specialist to develop a Benefits Plan.
You can also apply for Working Healthy on-line at http://www.dcf.ks.gov/Pages/Default.aspx - Click the "Apply for Services" button.
Q: Why isn't there a Benefits Specialist in every DCF Area Office?
A: In light of the present budget constraints, six Benefits Specialists seem adequate for statewide coverage.
Q: How do I get an appointment with a Benefits Specialist in my region?
A: You can call directly. The names, telephone numbers, and e-mail addresses are listed below. Please see the Benefits Specialist page to determine which specialist is for your county.
Kansas City Metro
Wichita and SouthCentral Kansas
Q: Why should I enroll in Working Healthy?
A: There are a number of advantages for enrolling in Working Healthy. Consumers enrolled in Working Healthy are able to have higher income, savings accounts, and retirement accounts. You will also have a Medicaid card, allowing you to maintain health insurance that in some cases pays for health care services not typically covered by private health insurance. If you have a spend down, you may pay a monthly premium instead, which is typically lower than the spend down. This again allows you to keep more of your income for other purposes.
Q: With the state's financial problems, will this program be discontinued in the future?
A: While there is no way to guarantee that any program will continue, Working Healthy has had strong support from both the Kansas Legislature, Kansas Department of Health & Environment/Division of Health Care Finance, the Secretary of DCF and DCF Leadership. It is considered a valuable employment initiative that is consistent with the DCF mission of promoting self-sufficiency.
Q: Does Working Healthy cover my spouse and/or children?
A: No, Working Healthy provides single-person coverage for an individual with a disability. Working Healthy is designed for adults with disabilities interested in working but who do not want to jeopardize their health care coverage. A spouse or child is covered only if they meet the Working Healthy eligibility criteria.
Q: I am not working right now, but would like to work. What can I do?
A: You can contact your DCF Worker and/or the Benefits Specialist in your area. They can assist you in contacting employment service programs such as Kansas Rehabilitation Services, Employment Networks, Job Service Centers, etc.
Q: Does an individual need to work 40 hours a month or more to participate in Working Healthy?
A: No. Consumers are eligible for the program if they are employed at or above the federal minimum wage, their countable earned income from competitive or self-employment exceeds the standard earned income disregard of $65.00 and they can demonstrate that either FICA/SECA deductions are made from their wages. Consumers are encouraged to work as much as they are able to increase their income and self-sufficiency.
Q: Why is there an age limit on eligibility for Working Healthy?
A: Working Healthy was established under a Federal statute, the Ticket to Work and Work Incentives Improvement Act of 1999. That statute established the age requirement of 16 to 64 years of age.
Q: Why does Working Healthy have an age limitation of 64?
A: While states are allowed a great deal of flexibility in designing their Medicaid Buy-In program, the age limit of 64 was established in the federal statute, the Ticket to Work and Work Incentives Improvement Act. This federal statute would have to be changed in order for states to raise the age limit. Consumers concerned about this age limitation may want to consider contacting their federal representatives.
Benefits Specialists are keeping track of people who are "aging out" of the program, and will follow-up with consumers to discuss what options might be available.
Q: When considering household income, including a spouse's income can really increase the Working Healthy enrollee's premium, as well as the spouse's spenddown. It may even jeopardize the spouse's health care coverage. Why does the spouse's income need to be included?
A: Legally responsible persons (spouse for spouse, parent for child) are always included for all medical programs. Some income is disregarded for both the enrollee and spouse. In light of the present budget situation in Kansas, it would be difficult to justify disregarding all of the spouse's income for Working Healthy enrollees. DCF staff will continue to review this issue and consider possible changes.
We encourage consumers who have questions about spousal income to work with their local Benefits Specialist to determine what income disregards may be possible.
Q: Why do consumers who are blind/visually impaired receive a higher rate for income exclusion for Blind Work Expenses (BWE)?
A: The Kansas Medicaid program cannot be more restrictive than a Federal program. The BWE exclusions in Kansas are consistent with the BWE income exclusions that the Social Security Administration BWE allows.
Q: Whose income is counted in determining the premium amount?
A: The consumer's income, and the income of any "legally responsible" person(s). Examples of "legally responsible" would be a spouse, or parent(s) of a child. If the consumer has a child or children, their income would not be counted because they are not "legally responsible" for their parent.
Q: Can other insurance premiums be used as Impairment Related Work Expense (IRWE) to reduce the income amount used in determining the Working Healthy premium?
A: No, other health insurance premiums do not meet the IRWE criteria because they are not directly related to a consumer's disability, which enables the consumer to work.
Q: Can a person who is Supplemental Security Income (SSI) 1619(b) eligible choose to convert to Working Healthy?
A: Consumers will not be converted into Working Healthy until their income and/or savings exceed the 1619(b) asset/income limit. Medicaid regulation requires that consumers be enrolled in the program that is the most "liberal". As Working Healthy has a "desk review" every six months and requires a premium payment for those with income above a certain level, and 1619(b) does not, the latter is considered more "liberal". However, 1619(b) eligibility is the "stepping stone" into Working Healthy. Once the 1619(b) asset/income limit is exceeded, a consumer may be eligible for Working Healthy.
Q: To whom do I report Impairment Related Work Expenses (IRWE) information?
A: Your IRWE information can be reported to your DCF Worker. You can explain why the expense is necessary for you to be employed, and your DCF Worker can explain which expenses are "allowable" as an IRWE.
Q: Are Working Healthy premiums an allowable IRWE expense?
A: No, however they are an allowable expense for Food Stamps.
Q: Can the $3.00 Medicaid co-pay for prescriptions be counted as an IRWE or BWE?
A: Yes. If the medication is necessary for a consumer to work and is a prescription relating to the disability on record, it is an allowable for an IRWE or BWE.
Q: Is assistance available for help paying Medicare Part D prescription drug co-pays?
A: Yes. Dually eligible (Medicare and Medicaid beneficiaries) are eligible for the Part D Prescription Drug subsidy. Contact your Benefits Specialist to find out more about this program.
Q: Why are there premium payments?
A: Consumers and advocates requested access to Medicaid health care for employed individuals through premium payments. A premium system is consistent with the way that most people access health insurance in the United States.
Q: Who do I contact if I have questions about my premium bill and where do I send my premium payment?
A: HP Enterprise Services is the entity that handles Working Healthy premiums. Questions about premium billing should be directed to HP Member Services (1-866-688-5009) Monday-Friday 8 am - 5 pm.
Checks or money orders can be sent to the following address:
HP Kansas Premiums
PO Box 842195
Dallas, TX 75284-2195