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Health and Employment Counseling: Frequently Asked Questions

Health and Employment Counseling (HEC) is a nine-month program for people who are not employed but are looking for work. It is a companion program to the Medicaid Purchase Plan (MAPP), which requires employment. If you would otherwise qualify for MAPP but don’t have a job yet, with HEC you can enroll in MAPP right away and get up to nine months to find a work activity that meets the requirement.

Download the HEC Consumer Guide, P-20220A and explore the frequently asked questions below to learn if HEC is right for you.

The definition of working is paid employment, self-employment, employment at a sheltered workshop, or employment in exchange for goods or services. No minimum number of hours is required. Examples include:

  • A job where you get wages from an employer.
  • Self-employment with a business that gives you income once a month.
  • In-kind work where you provide a service for someone at least once a month in return for something of value, such as doing yard work in exchange for a meal, walking your friend’s dog in exchange for transportation to appointments, or taking care of a family member in exchange for groceries.

Complete the HEC Application, F-00004, which is a self-assessment to help you find work. This is also called your employment plan. For help on your employment plan, refer to the HEC Consumer Guide, P-20220A.

Submit your completed application to the HEC program coordinator:

Mail: HEC Program Coordinator, PO Box 7851, RM 335, Madison, WI 53707-7851

Email: DHSHECmailbox@wi.gov

Fax: 608-223-7755

You should apply for MAPP before you apply for HEC. If you are eligible for MAPP or you are waiting for a decision on your MAPP benefits, then you can apply for HEC.

The employment plan is a tool to help you organize your employment goals and how you plan to achieve them within a nine-month timeframe. You fill out your employment plan as part of the HEC application. You must have a completed and approved employment plan to enroll in HEC.

You may write the employment plan on your own or with help from someone else, such as a caseworker, benefits specialist, or vocational counselor.

Enrollment in HEC lasts for up to nine months. At the end of nine months, you must meet the work requirement to continue to receive your Medicaid coverage through MAPP. Your nine-month enrollment period starts when we approve your employment plan. Important dates, including the start and end date of your HEC period, will be noted on the approval letter we send you.

You may participate in HEC twice within a five-year period. There must be at least six months between the end of your first and the start of your second enrollment. Any period of HEC enrollment, whether you use the entire nine months available or not, will count as one HEC period.

If you feel like you are making progress but might not be employed by the end of your nine-month HEC enrollment period, you can apply for a three-month extension. You must apply for an extension before the end of the seventh month of your HEC enrollment to prevent any gaps in Medicaid coverage. Fill out the HEC Extension Request form, F-00004A, and submit it to the HEC program coordinator. You’ll get a letter about whether you were approved for the extension or not.

HEC is intended for people who can be employed within a short period of time. If your employment goals will take longer than nine months to achieve, you should wait to apply for HEC when you are closer to achieving employment.

If you have not been determined eligible for Medicaid based on disability, you can apply for a disability determination through your local agency. Find a local agency near you.

It sometimes takes a few months to obtain the determination, so the sooner you start the paperwork, the sooner you can participate in MAPP. Remember, you should apply for MAPP before you enroll in HEC to make sure you meet all the MAPP eligibility criteria.

When you become employed during your HEC period, report this to your local agency and the HEC program coordinator right away. Fill out the HEC Employment Report form, F-00004B, and follow the instructions to send it in.

Glossary

 
Last revised November 16, 2023