Derek Shields >> So as I said, my name is Derek Shields, and I serve as the moderator for today's session. I'm now pleased to introduce our presenter so she can begin with her presentation. Debora Wagner spent 25 years working with legal services and law school clinical programs. Throughout her career, she has presented on benefits issues, including post-entitlement and return-to-work issues, to attorneys, vocational rehabilitation professionals, individuals with disabilities, and their families. From 2016 to 2022, she led the statewide network of Work Incentives  training and technical assistance for benefits planners in Ohio. Then in December 2021, Debora joined the staff of Cornell University, where she continues to provide Work Incentives  training and technical assistance. And with that, I'm pleased to welcome Debora and turn the session over. Debora, all yours.

Debora Wagner >> Thank you so much, Derek. I'm so happy to be here today. And I'm so happy to see so many people participating. This is simply wonderful. So today we're going to be focusing on return-to-work tools and tricks that are available to help you as you make this journey. So we're going to start by talking about the Ticket to Work Program itself and talk about what it is. Then we'll talk about tools you can use to keep your Social Security benefits when you start working. And then we'll talk about Medicaid and Medicare, because I know a lot of times that's a big concern for people as they're looking to work. And then we're going to talk about different programs that are available to help you to achieve your work goals. So let's go ahead and get started. 

So first, we're going to start by talking about Social Security's Ticket to Work Program. And this is a free and voluntary program. It's available for individuals ages 18 through 64 who receive a disability benefit from Social Security. And it doesn't matter whether you're getting SSDI and/or SSI, as long as you want to work, the Ticket to Work Program is for you. So that leads to a good question; what's the difference between SSDI and SSI? Well, Social Security Disability Insurance is a program for people who have worked and paid into the Social Security Trust Fund by paying FICA taxes from their wages. And when you have insured status, you're eligible then for this disability insurance program, SSDI. If you get SSDI, it's also possible that your dependents might be able to get benefits off of your earnings record. 

Supplemental Security Income is the other program. It's called SSI. And this is the program for people who do not have that insured status. In other words, people who've not worked and paid into the disability insurance system. SSI is really designed for low-income individuals. So Social Security will consider your income and your resources in addition to taking a look at your disability. So no matter which of these programs you get, you can use the Ticket Program to help with your return to employment. 

The Ticket to Work Program is going to connect you with free employment services. That's right. I'm going to say that again. Free employment services. They can help you make informed decisions about whether work is right for you. They can even help you prepare for work. Maybe you need help developing a resume or practicing those interview skills. Ticket to Work Program can help you with all of that. 

They can even help you find a paid work opportunity, Employment Networks in the State Vocational Rehabilitation agencies, which we'll talk about in more detail in a little bit. They are there to really help you find the right paid work opportunity for you. And they're usually very well connected with the different employers in your community. And they know what types of positions are available. And finally, the Ticket to Work Program can really help you succeed at work. So maybe you need some ongoing support, maybe a job coach or some other employment supports to be successful in work. And that's where the Ticket to Work Program can really help you. So I'm going to give you an example. 

I worked with a young man years ago, really smart young man. And he kept interviewing for jobs. And I finally said, "So what's happening with all these interviews you're doing?" And he said, "Well, I have a panic attack in the waiting room, and I never make it in for the interview." And I was like, that's why he's not getting any callbacks, right? So he worked with an Employment Network in our community to practice those interview skills, to learn how to manage that anxiety. And then he got the very next job that he went and interviewed for. So the Employment Network really helped him to get that job. But then they had a job coach who continued to provide support to help this young man manage his anxiety while he was on the job, so that he could be successful in that job. 

So we've got more information here. What is Social Security's Ticket to Work Program and self-guided tutorial? And both of those documents are available in the web links. So you can use those documents to get more information about Ticket to Work and to understand how it might be able to help you in your journey to employment. So that self-guided tutorial is Number 7 in the web links. And the What is Social Security's Ticket to Work Program is link Number 6. So if you're ready, if you think you'd like to connect with an Employment Network and look at using your Ticket to Work, you can start by calling the Ticket to Work Help Line. And they can answer your questions and help support you in finding the resources that you need to be independent and to really work on your financial success. So you can call the Ticket to Work Help Line. They're available Monday through Friday from 8 a.m. to 8 p.m. Eastern Time. And the phone number is 1-866-968-7842, or for TTY users, you can call 1-866-833-2967. And that's a great place to start. They can help connect you with Employment Networks. They can help you with finding help with your benefits information, which we're going to talk about in just a minute. It's just a wonderful place to start this process. 

So let's talk now about whether or not you can keep your benefits from Social Security when you work. I think a lot of people have the misconception that when you go to work, you're going to lose your benefits from Social Security. And there are lots of safety nets that are available to help support you when you go to work. So let's start talking about some of those safety nets that are available. 

So how does work affect my Social Security disability benefits? Well, these safety nets or safety features are really in place, and they let you keep your benefits while working. And Social Security calls these programs Work Incentives . These are programs and rules that help beneficiaries to enter, reenter, or continue employment, and they protect eligibility for benefit payments and/or health care coverage. We're going to talk about that today, too, until they can earn enough to replace their SSDI or SSI benefit payments with earnings from employment. So whether you're looking for your first job or you're returning to work after an injury or illness, Work Incentives can be available to help you through this transition to work. And these safety nets are so important. So let's talk about some of these. 

So the first I want to talk about is the Trial Work Period. And you might be thinking, "What is the Trial Work Period?" Well, the Trial Work Period, or TWP, is one of the many Work Incentives that's available to people who receive SSDI. So this is an SSDI-only Work Incentive. It's why we talked earlier about the difference between SSDI and SSI. You need to understand which one you have, so you know which Work Incentives are available to you. So the Trial Work Period is an SSDI Work Incentive that allows you to keep SSDI while you test your ability to work for at least nine months. And during this Trial Work Period, you're going to get your full SSDI payment no matter how much you earn in wages. That's an amazing tool. Think about that. No matter how much you're earning, you're still going to get your SSDI payment. Now, the key is that you're going to need to report this work activity to Social Security and continue to meet the other rules for disability that Social Security has. Anytime you're working on SSDI or SSI, you should make sure that you're reporting your wages to Social Security. That way, they know what Work Incentives they can be applying to help support you in your employment transition. 

So let's talk a little bit more about how the Trial Work Period is calculated. So the Trial Work Period continues until you have nine Trial Work Period service months. They don't have to be consecutive. Only the months that you work and earn more than the Trial Work Period level are going to count as Trial Work Period months. So Social Security is going to use the amount you earn in a month before taxes, so the gross amount of your wages, to decide if the month is going to count as a Trial Work Period month. So this year, if you earn $1,160 or more, or if you're self-employed and you work more than 80 hours in your self-employment, you're considered to have worked and used a Trial Work Period service month. So this is going to count towards that nine-month Trial Work Period. So this is a wonderful time for people to really test their ability to work. 

When I'm providing counseling to individuals, I always encourage them to make the most of their Trial Work Period, to earn as much as they possibly can, and know that they're still going to get the full amount of their SSDI payment each month. So this is really a great opportunity to test your ability to work and see if you can sustain work at that level. Now, the key is if, for some reason, you cannot maintain that work, if you have to stop, only the months that you worked and earned more than that threshold amount, that $1,160, or that you worked more than 80 hours in self-employment, only those months are going to count. So you might have somebody who starts a job and they work for three months, and then they figure that job is not a good fit and they stop working. The only months that count towards the Trial Work Period are the months that they worked and earned more than that threshold amount. So this gives people a possibility to explore maybe a couple of different jobs to find their niche, the right job that's the best fit for them. And they're still protected and getting the full amount of their SSDI payment each month. 

So if you'd like to learn more about the Trial Work Period, including understanding how the Trial Work Period works, what counts as a Trial Work Period month, and how the Trial Work Period affects your benefits, we've got an all-in-one, easy-to-read resource for you. We provide clear definitions and examples. We answer the most common questions that people may have about their Trial Work Period. And we provide helpful guidance for planning your work journey. Plus, we explain what happens after the Trial Work Period. And when you can learn all about the Extended Period of Eligibility or EPE, which is the next safety net available to people with SSDI. It's a 36-month safety net that allows you to keep working and still receive benefits in months that your earnings are below the Substantial Gainful Activity level, also known as SGA. And the amount this year in 2025 is $1,620 per month. For individuals who are blind, the SGA level this year is $2,700 per month. So those are some examples of common Work Incentives for people on SSDI. 

And you might be thinking, wait a minute, Debora, I'm not on SSDI. I get SSI or Supplemental Security Income. Well, you can't use the Trial Work Period, and you can't use the Extended Period of Eligibility. But I want you to know that there are Work Incentives for SSI, too. First, I want you to know that SSI will count less than half of your wages before they look at reducing your SSI payment. So people on SSI are always going to be better off financially when they go to work. They will have more money even if their SSI payment is reduced a little bit because of their wages. So I just wanted to make sure that you understood that. So let's talk now about whether you can keep your Medicaid or Medicare when you start working, because I don't know about you, but I need my medical insurance to work, right? I have to be able to get the care I need to be healthy and well so that I can go to work. So let's talk now about Medicaid and Medicare and how you can keep those benefits when you're working. 

So if you receive SSDI benefits or SSI payments of any amount, you can keep your Medicare or Medicaid when you go to work. That's an amazing thing that you can keep that health coverage. Even if your benefit payments stop due to earnings or work, and as long as you remain medically disabled, you may be able to keep your Medicare and Medicaid using some Work Incentives and buy-in programs. So we're going to talk about how to keep both Medicaid and Medicare when you go to work because we want you to be healthy and well as you transition to employment. It's great to have financial stability, but we need to keep healthy, too. 

So there are Work Incentives and programs that are available to help you keep Medicare and Medicaid. So for Medicaid, we've got two programs that we're going to talk about today. One is called 1619(b) Medicaid, or Medicaid While Working. And the other program is called Medicaid Buy-In. We're going to talk about each of those. And then we're going to talk about ways that people can keep their Medicare. There's an extended period of Medicare coverage that lets people keep Medicare for at least 93 months after that Trial Work Period that we talked about. And even after that, there's Medicare for people with disabilities who work. So there are some great safety nets for our health benefits in addition to safety nets for those cash benefits. 

So let's take a look at each of these and talk about how they work. So 1619(b) Medicaid is one of my favorite programs to talk about. This is just a wonderful Medicaid program. So if you receive SSI, you may qualify for continued Medicaid coverage even after your SSI payments stop due to earnings from work. And in order to be eligible for 1619(b) Medicaid, you have to meet the following criteria. You have to have been eligible for an SSI payment for at least one month. You have to continue to be disabled using Social Security's definition of disability. You have to meet all of the other non-disability SSI requirements. The big one there is that your resources have to stay under the SSI resource limits of $2,000 for an individual and $3,000 for an SSI couple. You also need to need Medicaid benefits to continue to work. But I think that's an easy one. Who among us doesn't need Medicaid coverage or a medical coverage? In case of an accident or an injury, or an illness, we need to know that we have medical coverage. And then you need to have gross earnings that are below your state's threshold of eligibility. And each year, they update those threshold amounts. You can find them on Social Security's website, and you can take a look at what those amounts are. 

So even for people who are not eligible for 1619(b) Medicaid, maybe you didn't get SSI, maybe you got SSDI, there's still a Medicaid program for you when you go to work. It's called Medicaid Buy-In. This is also a program that I would commonly recommend for people who would be eligible for 1619(b) Medicaid, but maybe they want to save more in resources, or maybe they're going to earn more than that 1619(b) threshold. So there are currently 46 states that have a Medicaid Buy-In program that allows you to pay a premium for Medicaid coverage. And you may qualify if you meet the definition of disability as established in the Social Security Act. Now, each state's Medicaid program is going to be different, so their Buy-In programs will be different. But most of them are going to require that you get earnings from work. So each state will define what work is a little bit differently, and you can usually find that information on your state's Medicaid website. So you can look and see what type of work activity is required to get Medicaid Buy-In in your state. Now, some states allow you to have significant earnings from work or self-employment, and many of them have higher resource limits than most Medicaid programs would allow. So this is a great way for people who are working, who want to save money, who are planning for their retirement, to keep Medicaid coverage to help them with their Medicaid costs. Under some circumstances, people who get SSDI benefits may be eligible for Medicaid Buy-In programs. And for many folks, this may be the first time they're eligible for Medicaid. I used to tell my clients, if you want Medicaid, go to work and I can get you Medicaid. And they said, wait a minute. I'll have more income and then I'll get Medicaid? Absolutely. With Medicaid Buy-In, that's absolutely possible. So you should check with your local Medicaid agency to find out what's available in your state. Again, you could usually find that on your state Medicaid agency's website, you may be able to go into a local Medicaid office and ask them about the buy-in program in your state. This is a wonderful way for people who are working to keep the medical coverage that they need through the Medicaid program. 

Now, what about people who have Medicare? So we've talked about two ways to keep Medicaid. We talked about 1619(b) Medicaid for people who had SSI and whose wages reduced their SSI payment amount to zero and we talked about Medicaid Buy-In. But what about Medicare? Well, first I want you to know that there's a Medicare program called Medicare for People with Disabilities who work. And this says even after you lose your premium free Medicare coverage because of your work activity, you can pay a premium. You can buy continued Medicare coverage as long as you're medically disabled. So you're eligible to buy this Medicare coverage as long as you're not yet age 65, because at that age, you would be eligible for Medicare based on age, not based on disability. You have to continue to have a disabling impairment, and you have to have lost your eligibility for premium free Medicare due to earnings from employment. So you had to have worked your way off of that Medicare that was premium-free. And the amount you're going to pay in your premium depends on how many work credits you've earned, and they're going to take a look at that and calculate your premium. If you look at those premiums and they seem kind of expensive, I want you to know that there's a program offered by state Medicaid programs that may be able to help you to pay that Medicare premium. It's called the Qualified Working Disabled Individual or QWDI, and that may be able to help you with that premium after you've lost your eligibility for premium free Medicare coverage. I used to use this all the time, because people used to lose Medicare as soon as they went to work and stopped getting their SSDI. But now there is an extended period of Medicare coverage. 

So for most people who get SSDI and their benefits stop due to work, they're going to keep Medicare, that premium-free Medicare, for at least 93 months after their Trial Work Period ends. This includes their hospital insurance, Medicare Part A, premium-free when you're in this extended period of Medicare coverage, their supplemental medical insurance or Part B if they're enrolled in that, and their prescription drug coverage through Part D if they're enrolled in Medicare Part D. So at least 93 consecutive months after the Trial Work Period. That is seven years and nine months, my friend. That is a really long time to keep that Medicare coverage after somebody has gone to work. So this is a wonderful safety net for the medical coverage. So if you're worried about your medical coverage when you go to work, I hope that you're hearing that both Medicaid and Medicare offers some amazing safety nets that allow you to keep your medical coverage even when you're working. 

So if you have questions about your Medicare coverage, if you're wondering how these programs might work for you when you return to work, we've got some resources for you. One is that you can go to medicare.gov so that you can take a look at that and explore that website. Lots of good information there. But you can also talk or chat with a live person. They have a phone hotline that's available 24 hours a day, seven days per week. You can call 1-800-MEDICARE. That's 1-800-633-4227. For TTY users, you can call 1-877-486-2048. So you can use those to talk to people about your Medicare coverage, about how you're going to keep your Medicare when you go to work, and they can help you understand and explore these safety nets. So I hope that what you've heard so far is that if you go to work, you can keep your benefits from Social Security by using these Work Incentives and you can keep Medicaid coverage and Medicare coverage even if you work your way off of your benefits from Social Security. So it's wonderful to know that there are all these safety nets to support people when they're returning to work. 

There are even tools that help people get right back on Social Security benefits if they lose them due to work activity. There's a program called Expedited Reinstatement or EXR, and it allows people who are terminated from their Social Security benefits because of work to get right back on their benefits within 60 months if their earnings drop and they're no longer able to work at that SGA level. So there are some great safety nets out there, and I don't ever want fear of losing any of your benefits to be a barrier to employment, because there are wonderful tools available to help you. So I'm going to pause now and ask Derek if there are questions so that we can get answering those questions about your benefits and your health coverage.

Derek >> Thank you, Debora. This is Derek speaking. We've been able to get through a good amount of the content and certainly appreciate the information that you've been sharing. Before we get to the questions that have come in, I do want to check in with our audience. As I mentioned earlier, we had a platform upgrade and that created an issue with our Q&A tool. We did receive some questions through the tool when it was functioning, but there might be some of you out there that have questions and want to get those in. We encourage you if you have access to email, to email your questions to us at ttwwebinars@ssa.gov. I'm going to say that again. It's ttw, as in Ticket to Work, webinars, with an s on the end, @ssa.gov. T-T-W-W-E-B-I-N-A-R-S@ssa.gov.

Derek >> We have our team repositioned to receive and respond to those questions and to forward them to me so we can engage Debora on the topics. In the meantime, we did have some questions come in, and I'd like to dig into those with Debora now. First, it goes back, remember, to the beginning of Debora's content, she covered a lot of things when we talked about the Ticket Program eligibility, we talked about maintaining Social Security benefits while working, and then, of course, the last section covering right into Medicaid and Medicare and keeping your healthcare coverage. Let's go back to the start. Debora, why does it matter if I receive SSDI or SSI? Like we have a couple people that say, you know, I'm not sure what it is. Can you just describe the importance of understanding which one, you know, you have?

Debora >> Absolutely. Thank you Derek. This is Debora. And there's several ways you can figure out which benefit you have, but it's important to know, before I go through the ways to figure it out, it's important to know. Because as I mentioned, there are different Work Incentives available depending on whether you're on SSDI or SSI. So if you are on SSDI, you can use that Trial Work Period and that extended period of eligibility. But if you're on SSI, maybe you're using a student-earned-income exclusion always, you're using that $65 and one-half the remainder, earned income exclusion. So it really does matter. 

So if you're not sure which one you get; one big clue is that the SSI payment rate for individuals this year is a maximum of $967 per month. So if you're getting $967 per month, you probably have SSI. If you're getting more than that, you probably have SSDI. And some people may actually be getting a combination of the two. So you can call Social Security and ask them which benefit you're getting. You can also log into your mySocialSecurity account and take a look, and you'll see there whether you're getting SSDI, or SSI, or maybe a combination of both of those benefits. Everyone can set up a mySocialSecurity account. There's information on the Social Security website at ssa.gov about how to go about setting up that account. And then you can not only use it to verify what benefits you have, but you can also use it for things like reporting your wages and monitoring your earnings records. So I highly recommend that my Social Security account. But there are different ways you can go. You can call your local office, you can walk into your local office, you can request a benefits verification letter, and you can use your my Social Security account. Once you know whether you're getting SSDI, or SSI, or a combination of the two, then you can work with a benefits planner to understand what Work Incentives are available for you, given your specific benefits. Thanks for that question, Derek.

Derek >> It's Derek. Debora, thank you. I appreciate that. And just to reinforce, Social Security is putting a great emphasis on creating a mySocialSecurity account. If you don't have one, as Debora said, it's a great way to learn which benefit you're on. And the new Social Security website, if you go there, ssa.gov, just saying that again, Debora mentioned it. You used to have to search around a little bit. Right here on the homepage, you're going to have a chance to open up ssa.gov and the first thing you'll encounter is sign in or create an account, and it'll take you through those secure steps in order to do so. It's a great way to stay up on your disability benefits, but also all engagement with Social Security. All right. Debora, the next question came in. You reviewed the Trial Work Period and talked about it. We had two questions about the Trial Work Period, basically on, can I start, and stop, and restart? What's the period of time for that flexibility? How does that work?

Debora >> This is Debora. Thank you so much, Derek. That's a wonderful question. So yeah, you can start and stop your Trial Work Period, and only the months that you earn more than the TWP level will count. So if there are months where your wages dip or where you stop working altogether, if it's below that $1,160 this month, that won't even count as a Trial Work Period month. And there's a 60-month window. So when they think you've used your ninth Trial Work Period month; they're going to look back 60 months and make sure that all nine of the months they're counting fall within that 60-month window. So I've had clients who maybe they start working and they work for a few months and they use three Trial Work Period months, and then they stop working and they don't go back to work for another five years. When they start working, if it's been more than 60 months, those old Trial Work Period months don't even count anymore. They're going to start counting anew from their Trial Work Periods. So I've had clients who've had many more than nine Trial Work Period months, because their work activity has been spread out over many years and they've never had nine Trial Work Period months in any 60-month window. Thanks, Derek. Great question.

Derek >> Excellent. I love the flexibility. You know, as we say, sometimes, like, you know, it's important to actually -- Trial Work Period, it is trying to see what capacity you have. So delaying it isn't necessarily the purpose of it, but you have that flexibility. The follow-up question on that is coming in around, kind of what are some of the reasons that you commonly see, I know you're given some description, but what are some more reasons that you commonly see people stopping Trial Work Period? And have you ever worked with somebody -- can you give an example of somebody that stopped and started again, and like what that outcome was? Like maybe a success story. Like bring this to life with an example of somebody you've worked with.

Debora >> Absolutely. This is Debora. Thank you, Derek. I appreciate that question. And like you said, the flexibility really is the key to the Trial Work Period. So I'm going to give you an example that we use when we teach all the time, and that is if we had somebody who wanted to work every year as Santa Claus at the local mall. Do they still have malls? But let's say they're at the local mall and they work only in December of every year, and they earn more than the Trial Work Period level amount, but only one month every year. Well, that person would never have nine Trial Work Period months in a 60-month window. And they could keep working that one month a year and never worry about using the Trial Work Period, and they would keep getting their SSDI payment, the full amount, every single month. So other people that I've used who have had a lot of success, were people who were maybe new to work and they were really thinking about, what can I do? I don't know. And so maybe they were going to try a couple of different job opportunities. Well, this Trial Work Period gave them a chance to try working here for a couple of months and there for a couple of months and not ever worry about, oh, am I earning too much? Am I going to stop getting my SSDI payments? They had that Trial Work Period to really figure things out. 

So I worked with a young woman, and she thought she could work full-time, and she was really ready. And she took a full-time job, and she worked about three months, and she realized that she couldn't really work full-time. And so then they spent the next year kind of figuring out how many hours she could work. So at first, they cut her way back down to 20 hours, and then she tried 25, and then she tried 23, and then she'd go back up to 30. But she was trying to figure out the right number of hours for her, given her medical condition, and the Trial Work Period allowed her that flexibility. Only the months that she worked and earned more than that Trial Work Period level counted as Trial Work Period months. So that entire time while she was fine tuning and finding exactly how many hours she could work comfortably; she was still getting the full amount of her SSDI payment. And it really is that flexibility that makes the Trial Work Period such a powerful safety net for people. Thanks, Derek.

Derek >> This is Derek. That's an excellent example, and really the purpose of the program is right there, to allow people that both the flexibility but the time and the space, in order to see what capacity exists. And not everyone is the same. And we encourage you to consider using your Trial Work Period if you haven't yet, in example, and you could be a success story like the person that Debora mentioned. 

As a reminder, we're accepting questions through email. If you have access to email, we would appreciate you sending your questions to us at ttwwebinars@ssa.gov. We can receive and respond. We do appreciate that. We've been getting them in since I announced that. Thank you so much. Let's move to the next one that we have here. I tried the Ticket Program, but then I couldn't work. Am I allowed to try it again?

Debora >> Great question, Derek. So absolutely. So if you stop using your Ticket, your Ticket is simply unassigned and you always have the flexibility to assign it again at a future date. And I think, Derek, that's a pretty common scenario. Maybe somebody's using their Ticket and they're making progress. Maybe their medical condition has a flare and they're not able to keep working, they need to take a break. But when they're ready to go back to work, when things are going better, they can always assign that Ticket again, and start that path to work. Again, these safety nets are so flexible. They really do allow people to try working and if things aren't right, they can take a break and adjust, and then they can go back to work when they're ready. So you can absolutely assign that ticket again in the future. Thanks, Derek.

Derek >> This is Derek. Thank you, Debora. All right. Let's switch gears a little bit here. Some of the Medicare, Medicaid area, while you explained it exceptionally well, it can be confusing. We've had a couple questions about it too. Can I keep Medicare, or perhaps Medicaid too for others that are listening, even if my employer offers health insurance?

Debora >> Thanks, Derek. This is Debora. Absolutely, you can keep your employer health insurance and Medicare and or Medicaid. A lot of times this works really well for people, because they may have employer-provided health insurance that has deductibles and copayments. Well, Medicare or Medicaid can oftentimes help cover those cost-sharing expenses. So it's absolutely possible to keep both. I've worked with a lot of individuals who've worked and become eligible for their employer offered health insurance, and they've been able to keep their Medicaid coverage. They've even used 1619(b) Medicaid. And they can use that Medicaid coverage to pay their employer-provided health insurances, copayments, and deductibles. And for people with SSDI who have Medicare, they're going to keep that Medicare for at least 93 months after their Trial Work Period. So they can use that Medicare together with their employer provided health insurance. And many of those folks, Derek, have little to no cost out of pocket for their healthcare coverage. So that's a great place to be. So yes, you can absolutely have employer-provided coverage with Medicare and or Medicaid at the same time. That was a great question. Thank you, Derek.

Derek >> This is Derek. Debora, I appreciate that. And when you think about the amount of time, like if you're on SSDI, you mentioned a number of months, actually it becomes years. But when you think about the Ticket Program and all the flexibilities that are built in to these Work Incentives , can you tell us once again the length of time that you can still maintain access to these health care benefits as you return to work or try work for the first time? I always think this is astonishing.

Debora >> Well, I'll start with the extended period of Medicare coverage. This is Debora. And for the extended period of Medicare coverage, you're going to keep your premium-free Medicare for at least 93 months after the Trial Work Period. Again, that is seven years and nine months. That's a really long period of time. And as I mentioned, if you still need Medicare after that, you can pay the Part A premium and continue to have that Medicare coverage. For people who are on SSI and go to work, they can keep 1619(b) Medicaid indefinitely, Derek. There's no time limit for how long they can keep that 1619(b) Medicaid status. And for individuals who use Medicaid Buy-In, again, there is no time limit on that. For the Medicaid Buy-In program, it's going to continue until the person turns age 65. So it's really remarkable how long these time periods are to keep these different types of medical coverage. And this is great, because not everyone's going to be able to work at a level where they're going to have employer-provided health insurance. So they've got continued medical coverage. And even the people who do earn at a level where they have employer-provided health coverage, they can keep these other Medicare and Medicaid programs to help with the cost-sharing expenses associated with their employer provided plans. So thanks for asking, Derek. I love emphasizing that point.

Derek >> This is Derek. Thank you, Debora. I think the importance, this is one of the myths that we know that's out there and sometimes we have WISE webinars to dispel these myths. It's important for us to counter the myth with fact. You can have access to these health care Medicare and Medicaid services for years, and it allows you to have confidence in transition, whether you get that, you know, full-time position a little bit later and access the employer health insurance. It allows you to navigate from job into career, and that's the whole purpose of the program. Somebody asks, how do I know if I'm receiving Medicare or Medicaid? Any tips on that one, Debora?

Debora >> Yes. This is Debora. And you should have an insurance card. Normally, your insurance card is going to say either Medicare or Medicaid. Some people have both, Derek, and a lot of times their card will say something like dual plan, because they call it being dual eligible, if you get both Medicare and Medicaid. So looking at that insurance card can be a fast and easy way to see which benefit they receive. They could also try contacting their State Health Insurance Information Project or SHIP. The SHIPs exist in every state, and they can help people navigate making decisions about Medicare Advantage plans and Medicare Supplement plans. But they can also look to see whether you have Medicare or Medicaid, and they can oftentimes give you some detailed information about your coverage. So the insurance card is where I would start, Derek, but there are other resources. We gave you information earlier about calling 1-800-MEDICARE. You can always reach out to your state Medicaid agency too if you have questions. Thank you, Derek.

Derek >> Thanks, Debora. This is Derek again. Yeah, that's really helpful, and I appreciate that contact, the SHIP. We can remember that, but also look at your card if you have access to that. And that you could be dual eligible and maybe have access to both. So we've gone through our first set of questions. Before I send this back to Debora to dive into our next portion of today's webinar, I just wanted to remind people we do accept questions today through our email address. It is ttwwebinars@ssa.gov. As I mentioned at the start of our session, we encourage you to submit your questions, but we also need them to be somewhat general in nature. They can't be specific to your detailed situation or they can't include your personal information, like personally identifiable details. So keep that in mind when submitting your questions. We can answer the general ones here. Of course, we want to answer your specific ones. We're just going to have to redirect you to our Help Line, and we'll provide that number before closing up today. And with that, I'd like to turn the session back to Debora so she can continue with her presentation. Debora, back to you.

Debora >> This is Debora. Thank you so much, Derek. I really enjoyed those questions. It's great when you hear that people are thinking about this information and processing it. So now we're going to talk about who can help you achieve your work goals. There's so many resources that are out there, and I really love sharing information with people about the resources that they can use to support them in reaching their work goals. 

So the first thing I'm going to talk about is, what kind of supports are available if you need help with your return-to-work journey or just starting work journey. So connecting with a Ticket Program service provider may be able to help you develop achievable goals, establish what steps you need to take to find and maintain the right job for you, or start your career if you're at the beginning of your path. Ticket Program service providers can also help you identify the type of career you might enjoy and any transferable skills that you have to bring into that job. So it's really important to think about using these supports to have the most successful transition to employment.

So there are two different types of Ticket Program service providers that we're going to talk about today, and you can use the Ticket Program to access both of these providers. So there are Employment Networks, also known as ENs, and your state Vocational Rehabilitation agency or VR agency. And these service providers are really specialized in helping people with disabilities explore their work options, build their businesses if they want to pursue entrepreneurship, and navigating the rules around disability benefits. Together, they can help form your employment team, your own personal team to offer you guidance, resources, and encouragement every step of the way on your employment journey. So let's take a closer look at what each of these providers is able to provide you. 

So an Employment Network or EN is a private or public organization. They enter into an agreement with Social Security to provide free employment support services to people who are eligible for the Ticket Program. And I just want to repeat that; free employment support services. That is amazing. You know, they say there's no such thing as a free lunch, but there is with Employment Networks, this is free help. And there are many state public workforce systems, such as American Job Centers, that are also Employment Networks that are called Workforce Employment Networks. So there are some of these Employment Networks that operate nationwide. There are others that may focus on specific geographic regions or specific disability populations. So it's important that you explore your options and choose the Employment Network that's going to meet your individual needs. If you're in Maryland, for example, you might prefer working with someone local so that you could do meetings in person. Or maybe you'd rather connect with a provider virtually from anywhere in the country. And with Employment Networks, you have that flexibility to choose the provider who's going to meet your needs. 

So how can working with an Employment Network help you? Well, they're going to provide you with a variety of services and supports that are really designed to help you on the path to employment and financial independence. And these include things like helping you identify what are your work goals? You know, how many hours a week do you want to work? What type of employment fields do you want to explore? They can help you with things with writing and reviewing your resume, preparing for interviews. Remember, I mentioned that young man who would have panic attacks in the waiting room. They were able to help him manage that anxiety so that he could be successful in his interviews and actually get the job. 

They can also help with things like requesting reasonable accommodations. So sometimes somebody might need something from their employer to be successful in employment. And Employment Networks are experts at helping you understand what the accommodation possibilities are and actually approaching the employer to make those requests. They also can offer benefits counseling so that you will understand exactly how your work will impact each of your benefits. So again, you're making that informed choice about going to work and you're just, you're busting those myths. Right? And you know exactly how your work is going to impact your benefits. And then Employment Networks can also help you with reporting your wages, because as we've talked about, you're going to need to report those wages to Social Security each and every month. And you can get help with that through your Employment Network. They can help you with setting reminders for wage reporting, helping you understand your options for how to report your wages so that you make sure that you're meeting that requirement. 

So let's talk now about your State Vocational Rehabilitation or VR agency, and how they might be able to help you as another valuable resource when you're pursuing employment. So these agencies offer in-house planning and one stop services that might be a great fit, whether you're launching a business for the first time, or maybe you're pursuing a new career direction. If you're thinking, I maybe want to try something different, or I need to learn a new skill to return to work. VR agencies are equipped to help you with those types of services. They specialize in vocational rehabilitation, which means helping people with disabilities learn new ways to work or adapt tasks to fit their needs. That might include retraining, maybe learning to use assistive technology, or developing strategies to manage work more effectively. They also support education and training goals. Whether you need an associate's degree, some sort of professional certification, or you need vocational school to return to work, your state VR agency can help you access the resources to make that happen. In short, VR agencies are there to help you build the skills, the confidence and the foundation for a successful employment journey. 

Okay, let's now review a few more points on VR agencies and how working with your state's VR agency can help you. So it's really good to start by understanding what VR agencies usually work with individuals who need more significant services. So normally your state VR agency is there to provide services that are above and beyond what you might get with an Employment Network. Things like training, education, rehabilitation. In many states those are types of services you could get. They may also provide career counseling, job placement assistance, even counseling about how earnings from work may affect your Social Security disability benefits. And again, I cannot emphasize that enough. That individualized benefits planning, understanding how your work is going to impact your benefits is so important. I don't want fear to be a barrier for anybody in returning to work. I want people to really understand what will happen to their benefits from Social Security, to those health benefits, so that they're making informed choices and can plan and be successful in working towards that financial independence. 

So you might be thinking, well, that sounds great. I would love some free employment support services. But how do I find the service provider that's best for me? Well, I'm going to give you a couple of options here. The first is you can call the Ticket to Work Help Line and you can get a list of service providers that would serve you in your area or that serve people across the country. Again, the Ticket to Work Help Line phone number is 1-866-968-7842. And for TTY users, you can call 1-866-833-2967. And the Ticket to Work Help Line is available Monday through Friday from 8 a.m. to 8 p.m. Eastern Time. But they also have a great website, the Choose Work website. And you can use the Find Help page and you can search by your zip code. 

So I want to find service providers near me because I want to be able to meet with them in person. Fantastic. Enter your zip code.. They'll connect you with providers in your area. Maybe you've got an idea of what specific services that you need to be successful employment. So you can actually search for providers by who provides these services specifically. Maybe you want to work with somebody who works with your disability type. So I want someone with experience working with the deaf community, or working with people with mental health diagnoses or people with developmental disabilities. You can use those searches in the Find Help page. You can search by disability type. You can also search by language spoken. So if English is not your first language, maybe it's American Sign Language or another language. You can search for providers who speak your language. Isn't it great that you can get services from people who literally speak your language? 

And you can also search by the type of provider you want to work with. Maybe you want to find an Employment Network specifically or maybe you'd like to look at your workforce Employment Network for your area. Maybe you want to connect with your State Vocational Rehabilitation agency, or find your PABSS organization. And we haven't mentioned PABSS, but PABSS is Protection and Advocacy for Beneficiaries of Social Security. And they provide free advocacy for people who encounter barriers or challenges in using these return-to-work services. So you can provide -- find any of those providers by going to the website and using that Find Help page. You get to set your search parameters and find the providers that you need to start your journey to employment. All right. So we are at another break for questions and answers. I'm going to ask Derek if we've got any additional questions that we need to be talking about.

Derek >> Thank you, Debora. This is Derek speaking again. I appreciate your review of the employment team members. Obviously focused a lot more on the Employment Networks and the Vocational Rehabilitation agencies, but also mentioning some others there as well. Yeah, we do have some questions about, you know, the ENs and the VRs and the services that they provide. So let's get into that. We have plenty of time to cover them. The first question is, do I need to use the Ticket Program to find work? I kind of like applying for jobs on my own. What's your recommendation there for somebody that's receiving SSDI or SSI?

Debora >> Great question. This is Debora. So you don't have to use the Ticket to Work Program to find a job. You're free to go apply for any position that you want on your own. But I would say stop and think about whether or not it might be helpful to use the Ticket to Work, because the Ticket Program offers free personalized support to help you navigate your job search. They also help you understand how work is going to impact your benefits. And they can connect you with resources that will make your transition less stressful and smoother. So you might really want to give that some thought. Even if you already found a job or you're pretty confident about your job search, working with a benefits counselor through the Ticket Program could be a game changer. They'll give you, again, that individualized understanding of exactly how your work is going to impact your benefits from Social Security and those health benefits. And they can guide you through important steps like reporting your work activity to Social Security, how to use those different work tools, those Work Incentives that are available to you. So you can absolutely go it alone, but you don't have to. The Ticket Program is here to support your success, help you protect your benefits, and help you build a path toward greater independence. So my attitude is why not take advantage of free help when it's available? But the choice is entirely yours.

Derek >> This is Derek again. Thank you, Debora. And, you know, with that, sometimes it also helps to review stories about folks who have done things that you're trying to do. So if you're out there listening and say, well, I could find a job, but then what happens next? You know, that reminds me of one of our success stories. Angel is his name. And, you know, he was receiving benefits, but a friend of his was at an employer and said, look, we're hiring, and this company I'm working for is looking for people with disabilities to employ. And he actually found his job on his own, but then he was concerned what that income would do to his benefits. So he then assigned his Ticket and started receiving services really after job offer. And so, you know, go to the website, choosework.ssa.gov. One of our sections is success stories. And if you go through there, you can find Angel's success story. It's titled Wingman. He was in the US Air Force and had some injuries and really took a turn in his career. But in, you know, his next phase is now working through the support of an EN that was able to retain that job. So love that question. You have the flexibility. Let's get to the next question now. Debora, what if I'm unsure about the type of work I am able to do? You know, we hear from so many people that said, you know, I had this one career path in mind. I got my education or I had work experience, but now I can't do that. Can you talk about how ENs or perhaps VRs too could help in the planning process? ^P And specifically with getting into a little bit about an Individualized Work Plan and how an EN can help people map out, kind of, how they get to a place that they're not quite sure, you know, even what it might look like?

Debora >> This is Debora. That's a great question. So if you're not sure about what kind of work you'd like to pursue, you're not alone. I think sometimes people may even have an idea. But when they get more information, they're not so sure it's a good fit. But the Ticket to Work program is really built to help with exactly that type of issue. So Ticket to Work service providers can sit down with you. They can help you explore your interests, your strengths, your past employment experiences. They can help you to identify career paths that really align with your goals and connect you with any training programs, certifications or educational resources that you're going to need to set yourself up for success. So you don't have to have it all figured out before you start. Whether you're just curious about a new field, or just want to know what options are out there, the Ticket program offers guidance and support to help you discover a career that feels meaningful and achievable for you. Thanks, Derek. I love that question.

Derek Shields >> Debora, this is Derek again. Outstanding. So let's get into the next one with, you know, leveraging the plan. You mentioned some of the services and supports that are available. You went through things like helping with asking reasonable accommodation. When you think about pre-employment, what are some of the common things that services and supports-wise that an EN can provide that makes it a valuable step? We're getting into the unknown. And if I'm concerned about how I'm going to approach my job search, what are those pre-employment services that you would really want to emphasize for those folks that are with us today?

Debora Wagner >> This is Debora. Thanks, Derek. So, yeah, you know, your Ticket to Work providers can help you with all kinds of pre-employment services. Again, that career exploration, finding the job that's right for you and your abilities. They can offer help finding educational or training programs that you might need to enter that career path. They can help you with things like writing your resume or updating your resume if you're returning to the workforce. They can help you with interview skills, job exploration, you know, just making sure that the job you're thinking about is really the best fit for you. So they can offer a wide variety of services to help you get ready for work. And, again, I think one of the really important services is that benefits planning piece, so that all of your benefits questions are answered. You know what to expect when you do start working. You understand how to report those wages. Just having that information up front tends to make people a lot more comfortable when they start working. They know what to expect. They know what's going to happen, so they can relax about the benefits issues and really focus on doing their new job. Thanks, Derek.

Derek >> This is Derek again. Excellent. And here's another question. Do I have to work full-time? Pretty straightforward. What are your thoughts there, Debora?

Debora >> Yeah, Derek, this is Debora. Not necessarily. So the Ticket Program supports people through all different types of work. That could include part-time work, maybe seasonal employment. Ultimately, the goal of participating in the Ticket Program is to reduce and eventually eliminate the reliance on those Social Security benefits. But you're almost always going to come out ahead earning a paycheck from work as compared to just living on benefits. So while the goal of the Ticket Program is to find full-time employment, part-time work can be a step on that journey to full-time employment. I think about my own journey to work. I didn't go out one day and just get a full-time job. You know, I worked a part-time job in college. I worked a part-time job during my breaks and things like that. So the Ticket to Work Program can support you, even in part-time employment, as a stepping stone to working towards full-time employment. Thanks, Derek. Back to you.

Derek >> Excellent. This is Derek again, and we have another question. You mentioned the services that ENs can provide and the services that the VR agencies can provide. Can you talk a little bit about, is it okay to work with both? Can I work with both at the same time? Like how do I choose which one to go to? Is there a bad choice?

Debora >> This is Debora. So you can work with both VR and an Employment Network, but not at the same time. So in some states, you can work with an Employment Network after your State Vocational Rehabilitation agency closes your case. And this is a program that's called Partnership Plus. So in many states, your State VR agency is going to close the case after 90 days of successful employment. But some people need support services beyond that 90 days. And Partnership Plus allows the person to then work with an Employment Network who's entered into an agreement with the state VR agency to provide that ongoing support and additional transition services, even after the person's been working for a while. 

Now, an EN may offer continued support health services to help you maintain employment, maybe to increase your earnings over time. If your state doesn't have a formal Partnership Plus agreement, you can still work with an EN after your VR case closes. So you've got some options there. But the key is to find the provider that's best for you. And as we talked about, sometimes State VR agency might be a better choice if you need more comprehensive services, if you need more rehabilitation, maybe some complex education. You need that associate's degree. Maybe you start with the VR agency. And then Employment Networks can provide those ongoing, long-term supports. Now, some people don't need that intensive service at the beginning, and they can just start with an Employment Network. But the Ticket Program is flexible, and it allows you to decide where you want to start and what types of services you need specifically. So back to you, Derek.

Derek >> Thank you, Debora. This is Derek speaking again. With that example you gave, so I work with the VR, my Ticket's assigned to the VR, I get more comprehensive services, maybe some — I get an associate's degree. And then I actually find a job. So my case is closed with the VR. And then you mentioned that I could work with an EN later. Post-job acquisition, post-starting a job, what's the value in the services and supports an EN provides around, we'll call them job retention services? Do you want to touch on that a little?

Debora >> Absolutely. So there are all kinds of retention supports that people may need. Maybe you need a job coach on an ongoing basis to help you navigate the employment world. Maybe you're planning your next step and thinking, you know, what if I could get a promotion, or I could advance in my career somehow. Maybe the first job you had that you worked the 90 days at wasn't the right job for you. So maybe you need to explore other options. But keeping the job is just as important as getting the job, right? We want people to be successful and to be able to transition to financial independence. So getting supports around those retention services can be really important to help you keep the job and succeed in the job. Thanks, Derek.

Derek >> Oh, no, thank you, Debora. You know, as we wrap up the second Q&A and we turn to close today's session, I just really want to thank you for your presentation, and also I've enjoyed, you know, bringing the questions from the audience to you and having this conversation. You know, when you think about helping people retain their health care benefits, retain their Social Security benefits, and get the employment team services, you've covered a lot of territory. One last opportunity for you to help perhaps motivate some folks that are thinking about trying the program. Anything that you'd like to say in closing today?

Debora >> Thanks for that opportunity, Derek. I appreciate it. This is Debora. And I just have to say, I think there are so many myths out there, and that people have fear preventing them from going to employment. And if they truly understand all of the tools that are available, free employment services through an Employment Network or your state VR agency. Free help understanding how your work is going to impact your benefits. And learning about all of the tools that are there to help you and support you in your journey to financial independence. I love this work. I think it's so important for people to have factual information, and to use all of the tools that are made available to them to be successful in employment. So thank you so much for giving me the opportunity today to present and to talk with you, Derek. I really appreciate it. Thank you.

Derek >> Thank you, Debora. We appreciate you. And we'll turn now to wrap up the session. With that in mind, everybody, the Ticket Program is here to support you no matter where you are on your employment journey. And remember that going to work isn't just about the paycheck, but it's also about these themes that Debora has covered, independence, confidence, and setting and reaching your own goals. They're important, and we want to help you keep moving forward. How you move forward and what you do to get started, well, that's a question we get all the time. 

As we have on the screen now, we want to make sure that you find the point of entry. First, of course, it's important to know your eligibility. You need to be 18 through 64 years old and receive Social Security Disability Insurance or Supplemental Security Income due to disability. And when you do determine that, you can start by calling the Ticket to Work Help Line. You can do that at 1-866-968-7842, or via TTY for those who are deaf, hard of hearing, or have a speech communication disability. That's 1-866-833-2967. Of course, that is one point of entry for you to determine your eligibility or confirm the types of ENs or VRs that are out there to support you in creating your Individual Work Plan. Or you could visit our website at choosework.ssa.gov. That's an option for you. Using the Find Help tool, like Debora described, that's on that Choose Work website under the Find Help section. And you have an ability to filter by the type of EN and the services they provide. So we don't care really how you start. We just encourage you to get started either through the telephone call or through the website. 

Of course, we have different ways for you to stay connected with us, and we invite you to stay connected and informed with the Ticket Program activities. One easy way to do so is by subscribing to our Choose Work blog and signing up for email updates. Just visit choosework.ssa.gov/contact. There you'll find the subscription options and more ways to stay engaged. If you prefer updates be sent straight to your phone, you can opt in to receive text messages, as many people do, with webinar announcements, new success story posts, and a lot of helpful tips to use on your employment journey. To do so, simply text ticket, T-I-C-K-E-T, to 1-571-489-5292. For some of you, standard messaging rates may apply, and that will depend on your specific mobile phone plan. If you have any questions or need support, you can always use the email address of TicketToWork@ssa.gov. That's available for receiving general inquiries or specific ones that could be rerouted. Whether you're just getting started or looking for guidance along the way, the Ticket to Work team is here to help and support. 

And finally, we invite you to join us for our next WISE webinar. This one will be on November 19, and it's entitled “Ticket to Work for America's Veterans.” We're excited to showcase this again this year. Registration is available at choosework.ssa.gov/wise, or you can contact the Beneficiary Support Help Line  at 1-866-968-7842 or TTY at 1-866-833-2967. Thank you again for attending today. This ends today's webinar.