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M-WIN (Medicaid Work Incentive Network)
Affordable Health Insurance for Working West Virginians with Disabilities

M-WIN is a work incentive for people with disabilities or chronic health conditions.

It allows individuals who work, to pay a monthly premium and keep or obtain Medicaid healthcare coverage.

M-WIN eliminates a major barrier to employment - losing current healthcare benefits when an individual with a disability returns to work.

It also creates an incentive for individuals with disabilities to obtain employment and earn health care coverage.

M-WIN members can earn more money and save more money than Medicaid normally allows.

Hundreds of West Virginians with disabilities are benefiting from M-WIN.

M-WIN Premiums

"I have struggled for years to keep working. This program lets me work some, go to required doctor appointments and get very needed medications."*

M-WIN is health insurance and a premium is required. A $50 enrollment fee includes the first month's premium.

M-WIN coverage begins the month after the enrollment fee is paid. You will receive a monthly statement with a coupon to return with your payment. Premium payments are due by the 16th of each month.

The monthly premium varies based on the worker's monthy gross income, and can be as little as $15 per month. Your local DHHR worker will send a letter informing you of the monthly premium amount.

M-WIN premiums are reviewed every six months.

Eligibility

"My insurance through my employer made it too expensive to receive my treatments. M-WIN allowed me to keep receiving my treatments at an affordable price."*

You may be eligible for M-WIN if:

  • Employment: You work in a job at or above minimum wage.
  • Disability: You have a disability or chronic health condition that meets the Social Security Administration's standards (SSI or SSDI) or state guidelines as determined by the West Virginia Department of Health and Human Resources (DHHR).
  • Assets/Resources: Your assets are counted but do not include your house and car.
  • Income: Your unearned income (like SSDI) can be no greater than the Federal SSI benefit rate plus $20.
  • Age: You are a West Virginia resident between the ages of 16 and 64.

Medicaid Enrollment

"I feel M-WIN is the best program for someone who is disabled but who still wants to contribute to the workforce. It helps my self esteem."*

Applications for M-WIN are taken weekdays at each county DHHR office. Your local DHHR worker will determine your eligibility for enrollment in any Medicaid program, and specifically for M-WIN if you are working.

Office locations can be found on the DHHR website at http://www.wvdhhr.org/bcf/county.

M-WIN is a Medicaid coverage group. Eligible members receive the same medical coverage as regular Medicaid.

M-WIN eligibility is reviewed every six months.

Additional Information

For more information about M-WIN please contact:

DHHR
Bureau for Children and Families
Client Services Unit
800-642-8589

For Premium Payment Issues, please contact:

Health Management Systems, Inc.
877-355-7160

M-WIN was developed through a Medicaid Infrastructure Grant from the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services.

* All quotes are directly from M-WIN members.

Mission: Providing leadership in the development of services and supports for persons with disabilities
© 2005-2015 Center for Excellence in Disabilities West Virginia University