WISE Ticket to Work Webinar
Putting it Together: Healthcare and the Path to Employment 
September 25, 2019

Speakers: Sarah Hyland (Moderator); Keri Harrington and Ashley Palma (Presenters)

SARAH>> Good afternoon and welcome to today's Ticket to Work webinar, "Putting It Together: Healthcare and the Path to Employment."  
My name is Sarah Hyland. I'm a member of the Ticket to Work Team, and I'll be your moderator for today's webinar. We're so glad you're able to take time to spend with us today to learn about Social Security's Ticket to Work Program and how it can help you as you start your path to financial independence through work. Each of us has our own path to follow, and we hope you find some information today that will assist you in moving forward on your path to employment and financial independence. 
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Today's webinar is being recorded, and a copy of that will be available within two weeks on the Choose Work website, which can be accessed at: http://bit.ly/WISE_OnDemand. This link, as well as others, can be found in the Web Links pod that we just talked about at the bottom right-hand corner of your screen. This is titled, "WISE Webinar Archives." 
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As I mentioned earlier, my name is Sarah Hyland; and I am a member of the Ticket to Work Team. I'm excited to be here with you today as your moderator. 
We're delighted to have with us Keri Harrington and Ashley Palma. Keri Harrington works for Granite State Independent Living, GSIL, in New Hampshire and is the Director of Social Security's Work Incentives Planning and Assistance Program for all of New Hampshire and a portion of New York. She is a certified Community Work Incentive Coordinator, and she has been serving beneficiaries in this role for nine-and-a-half years. She has been working in the social service field for over 14 years. 
Ashley Palma is a Certified Community Work Incentive Coordinator, CWIC, for Granite State Independent Living in New Hampshire as well. She has been a CWIC for the past three and-a-half years. She works closely providing benefits counseling to local vocational rehabilitation offices as well as employment networks at GSIL. 
Thank you all again for joining us today. We have a very informative session planned for you, and our guest presenters will be discussing work incentives; the impact that choosing work may have on your Medicaid and Medicare benefits; and benefits counseling and service providers.  
By the close of today's webinar, you will be able to better understand your Social Security disability benefits; understand how the Ticket program can help you choose to work; recognize the myths and the facts surrounding work and its impact on Medicare and Medicaid; be able to access additional resources related to the Ticket program, Medicare, and Medicaid. 
With that, it's my pleasure to introduce Ashley Palma, who is going to start us off with the Ticket to Work program and support on your journey to work. 
Ashley, over to you. Thank you. 
ASHLEY>>Thank you, Sarah. 
Today we're going to talk briefly and quickly about the Ticket to Work program, what it does, how it works, and the different ways that it can benefit you. Then later on in the presentation, you'll hear Keri talk to you about the different work incentives that are available. 
To start, the two programs that you'll hear us mention a lot throughout this program about Social Security are the Social Security Disability Insurance, or SSDI, and Supplemental Security Income, SSI. If you receive one of these benefits and you're looking to go back to work, the first thing that you're going to do is decide if that's the right choice for you.  
While obviously that is your decision, there are some benefits to the Ticket to Work program that can help you to make that decision a little bit easier.  
So what is the Ticket program? 
The Ticket program is a free and voluntary Social Security program. You are not required to participate in it if you choose not to. What it can do is offer some career development for individuals between the ages of 18 through 64 who receive that Social Security Disability Insurance or that Supplemental Security Income benefit. 
What the program does is it's going to help you with employment services...so are you looking to decide is work right for you, are you prepared for work, do you have a résumé, do you have references, do you know how to write a cover letter, all of those things...and also, it can help you to even find a job. Maybe you don't know how to go about that job search, so it will help you to figure that out as well as help you succeed in work. So they can be there to help you with the interview process and make sure that you understand what you should be wearing to an interview and all of those things as well. 
So how does the Ticket to Work program work? 
If you choose to participate in the Ticket to Work program, you will work with a provider either through an employment network or your state vocational rehabilitation agency. These agencies can help you with:
Career counseling...so what kind of career would be best for you, what are your skills, what would your skills best be helped with? 
Again, they can help you with writing your résumé. Have you not updated it since the last time you had a job?
Interview advice...how should you act an interview, what should you wear, how to great an interviewee?
And, as I said before, assistance finding a job. 
So why would somebody use the Ticket to Work program? 
The Ticket to Work program can help you to determine whether or not work is going to be the right choice for you. Some individuals maybe don't need that help making those decisions, and they don't need the help finding those jobs; but if you do need the help, then it can help support you in making sure that you're making the right decisions that are best for you. 
A part of the Ticket to Work program is having counseling available to you to go over the work incentives that Social Security has in place, and Keri is going to talk a little more about specifically what those work incentives are. However, Social Security does have more than 20 work incentives put into place that help individuals when they go back to work. These work incentives will help make it possible for you to explore work while helping maintain your benefits. Some of those, what they can do is help you keep your Medicaid and/or Medicare depending on your state; have access to individualized services and supports, again, to help with the interviewing, job finding, all of those; and help you keep some or all of your benefit payment as you transition to work. 
A big thing that people always say is, "If I go back to work, I'm going to lose my benefit." That isn't always necessarily the case, and with the Ticket to Work program you have access to benefits counselors who can help guide you through that process and help you understand at what point does this tap into my benefit, at what point do I lose my benefit? 
Today we're here to talk mostly about the health care portion of it...so Medicaid and Medicare; however, there are a lot of other employment-related supports that come through the Ticket to Work program for SSDI and SSI. A good resource for anyone to look at if they are curious about all of the work incentives in the whole process is Social Security's Red Book. If you look in the Web Links pod that they have provided for you, you can find the link to the Red Book through the link called "Social Security's Red Book."  
Healthcare and the Path to Employment...a big misconception that I think we hear a lot is, "If I go to work, I'm going to automatically lose my Medicare or my Medicaid," maybe both if you have both, right? However, that is not true. You still have the possibility to go back to work and maintain both your Medicaid and your Medicare. There are different work incentives that allow individuals to maintain their Medicare, as well as each state has their own what we call "Buy-In programs" for Medicaid that can help you to maintain your Medicaid. Keri is going to talk more about each one of those. 
KERI>>So we're going to talk about first Medicaid and work incentives. If you remember, Medicaid is a state-run program versus Medicare, which is a federal.  
First, there are two important pieces to Medicaid when you go to work. There is Medicaid while working, also called Section 1619(b) Medicaid continuation, which is an SSI work incentive. Then there are Medicaid Buy-in programs that most states do have. 
First, we're going to talk about Medicaid while working or, again, Section 1619(b). If you receive SSI and your benefit stops because you are working, you could qualify for 1619(b). You have to have at least one month prior to your benefits stopping have been eligible and on Medicaid. You have to continue to meet Social Security's definition of disability. You need to still meet their non-disability requirements, which are the resource or asset limits, the unearned income limit...which is like Worker's Comp, child support, unemployment. 
You need to need Medicaid. Social Security will send you a questionnaire when you transition off benefits asking, "Have you used Medicaid in 12 months, will you need to use Medicaid in 12 months, will you be unable to afford medical bills if you do not have Medicaid?" So that's important to know. You need to answer that questionnaire to be eligible. You also have to have gross earnings below your state's threshold amount.  
So what is a threshold amount?  
It's what Social Security uses to see if your earnings are low enough to qualify for the Medicaid continuation 1619(b). It's based on the amount of earnings that would cause your SSI payment to stop in your state. Each state does have a different amount, so that's important to know...it's not universal, there are different amounts...and then the average of Medicaid expenses for your state. So for the most up-to-date threshold amounts, they do change yearly, you can go to the Web Links pod and select the "State Threshold Amounts," and that will send you to the link. 
There are also some things you need to be aware of. Social Security is looking at your gross earnings, but they will take some special work incentives into play to see if your earnings are above the threshold:
There are impairment-related work expenses, which are expenses you need to be able to work that you pay out-of-pocket for...like prescription copays, medical copays, durable equipment, medical equipment. There's a whole long list.
Blind work expenses, which are like impairment-related work expenses except for someone who usually is blind by Social Security's definition.
A plan to achieve self-support or a PASS.
If you spend money out for a personal care attendant or another type of publicly-funded attendant.
And then if you have a lot of medical expenses that go above what your state considers, 
So another Medicaid work incentive that is important to know is called a Medicaid Buy-in Program. It's called a buy-in program because a lot of states do have a monthly premium cost...not all; so, again, you need to look into your state's eligibility and their requirements. You may qualify for this if you meet the definition of disabled under the Social Security Act or your state's definition if it's different. This is a work incentive that's used a lot by SSDI, or Social Security Disability Insurance beneficiaries, where they can have access to Medicaid. 
A lot of Medicaid Buy-in programs have higher income limits and higher resource or asset limits, so it does allow people to have access to Medicaid where they might have not been able to before; and it does allow them to save. That's an important piece. When you're working, you might be able to save some money that you might have not been able to before. 
In the Web pod links, there are some links where you can look up your state's information on these programs. Again, 1619(b) or Medicaid while working is a Social Security work incentive; and you can, again, find this link in the Web pod under "Medicaid While Working." 
For the Medicaid Buy-in Program, you need to go to your state's Medicaid agency. You can go to their webpage and look at what their eligibility requirements are. You can find that, again, in the Web pod under "State Medicaid Agencies." 
Now we're going to switch gears, and we're going to talk about Medicare and work incentives. Remember, Medicare is a federal program under Social Security.  
There are some work incentives for Medicare when you go to work because, again, a lot of people do panic when they go to work that they're going to lose their medical coverage. So we're going to talk about the extended period of Medicare coverage or the EPMC for short. Then there is Medicare for people with disabilities who work, which gives you access to Medicare. I'll talk more about that. 
Again, one of the things that most people are most concerned about understandably when you're working is losing medical coverage. The extended period of Medicare coverage protects a person's Medicare from ending due to work right away, so you're able to keep your Medicare for a little bit longer if your SSDI benefit does stop because of work. 
Most SSDI beneficiaries whose benefits stopped due to work can continue to receive their Medicare for at least 93 consecutive months after their trial work period ends. Now, this does vary depending when your benefits stopped and other considerations. So we will talk at the end of this presentation about how to access benefits counselors. It's really important to speak with someone about how all this works because you might be able to get that a little bit longer. It just really does vary, and you need to know that.  
Again, Medicare is made out of different parts. Part A is your hospital insurance; Part B is your supplemental medical insurance...and again, that is automatic but you can opt out...that's if you're enrolled; and then Part D is your prescription drug coverage...and again, you do have to enroll in that separately, so you can opt out of that. 
Now, to qualify for the extended period of Medicare coverage, you have to already have Medicare; and your benefit has to stop because it's just a protection when you're not getting a benefit anymore of your Medicare continuing. And you can't be medically improved. Social Security does do medical updates every once in a while, and you can be deemed medically improved. So again, your benefit has to be suspended due to work. 
Another option is Medicare for people with disabilities who work. This is if your premium-free Medicare coverage ends. Again, Medicare Part A is free; you have a premium for Medicare Part B and possibly Part D. When they say, "premium-free," they mean your Part A Medicare. So this is if your EPMC, or the extended period of Medicare coverage, ends; so that's after you use all those work incentives. You could possibly be eligible if you are not yet 65 because you become eligible as a person who's 65 or older for Medicare at 65. 
You have to still have a disabling impairment; so, again, you can't be medically improved. And as I just stated, your Medicare has to have stopped due to work.  
There are different times you can enroll in Medicare. For this information, you can call Social Security. Social Security's general national hotline number is 1-800-772-1213, and they'll direct you to your local office.  
For help with paying premiums, you can call Medicare for more information. You will need your Medicare number; and they'll ask you what state you live in because, again, that program is called the Medicare Savings Program, and there are a few other programs. But depending on your state, depends on what might be available to you. Medicare's number is 1-800-Medicare, so M-E-D-I-C-A-R-E. 
SARAH>> All right, Keri and Ashley, thank you so much for talking through the Ticket to Work program and the path to employment and work incentives. We are going to go ahead and take a few minutes to address some of these questions that we've been receiving from our audience on these topics, if you're both ready. 
Keri, I have a question for you to start: "What happens if I move to another state with different thresholds?" 
KERI>>If you move to a different state, you need to be prepared for what their eligibility is. So if you qualified in one state that had a higher threshold into a state that has a lower threshold, you might not qualify because it is a state-by-state thing. So you do have to be prepared by that. Again, that could be the opposite; you could come from a state that has a lower threshold and move to a state with a higher threshold, and you might be eligible still. So you really do have to refer back to what the state thresholds are. 
SARAH>>Thank you, Keri. 
"If I'm offered employer-sponsored insurance, what happens to my Medicare and/or Medicaid?" 
ASHLEY>>Keri, do you want to take that one? 
KERI>>Sure, so if you have employer insurance offered to you, you have to consider a few things if you have Medicare or Medicaid. First, you have to consider what that employer-sponsored insurance is...how much is the monthly premium, what will it cover, are there deductibles, copays? And then you want to look at your Medicare and your Medicaid to see what they cover and how much those premiums are. 
You want to be able to sit down with someone and look at all the different pieces to see what might be the best fit for you. Should you take them for your sponsored insurance? You could possibly stop your Medicare or your Medicaid because you want to be able to have everything you need covered, so it's really important to look at all of that. It really is an individual thing. We'll talk about, again, how to reach a benefit counselor in your state. So it's really important to reach out to someone and talk about what might be best for you. 
SARAH>>Okay, thank you. 
"What happens if I take my employer's insurance and I stop working? If I stopped my Medicare Part B and/or Part D, can I get it back?" 
KERI>> It's Keri again. If you take the insurance from your employer and you stop working for any reason, and you stopped your Medicare Part B and/or D, you can get it back. It's called a "special enrollment period" you have. You have to have the notice saying that your employer sponsored insurance ended. You can contact Social Security to re-enroll in Medicare Part B. You have seven months from the date that insurance ends to enroll. After that, there could be penalties. So you really want to pay attention and enroll as soon as you can. 
For Part D, you only have 63 days...so about two months...to enroll in a plan; and, again, you just need that notice that your employer-sponsored insurance ended and that you were covered during the time you did not have Medicare. So that's the most important piece Social Security is looking at...did you have other insurance during the period you stopped your Medicare. 
SARAH>> Ashley, the next question that I have is for you: "What are work incentives?" 
ASHLEY>> Work incentives...another way to put it is we call them "special rules." What they are, are they're guidelines that Social Security has put into place that allow individuals to go back to work, to try it out, make sure it's going to be the right fit for them before they lose their benefit right away. So it just gives you that period of time to test it out and make sure it's going to be the right fit for you while maintaining those benefits. 
SARAH>> Great, thank you, Ashley. I have another question for you: "How many work incentives are available?" 
ASHLEY>> There are over 20, but it's going to depend on what Social Security program you're on. There are different work incentives for SSDI as there are for SSI.  
SARAH>> Okay, thank you so much, Ashley.  
The next question is for Keri: "If I'm working, do I lose the Medicare Savings program?" 
KERI>> Okay, so that really does vary. The Medicare Savings program has income limits, and they don't count your earnings dollar-for-dollar...meaning there are some disregards, so it does lower. But depending on what your Social Security benefit is and depending on how much you're making a month could depend if you lose it or not. Again, I keep referring you back; but it's really important to touch base with a benefits counselor and talk it through. We can run through the numbers and tell you if it will end, when it will end.  
It really does depend, and there are three different levels; so again, depending on what income you have will depend on whether you will continue to have the Medicare Savings program or not. 
SARAH>> Thank you. Keri, I have another question for you: "If I'm working before my 24-month Medicare waiting period is up, do I still get Medicare?" 
KERI>> Yes, you will still get Medicare even if you are working before that 24-month period is up. That automatically comes to you at 24 months. The only time that might not happen is if you are deemed medically improved for any reason during that time. But if you are still eligible for benefits, even if they are in suspension, you can get your Medicare after your 24-month waiting period is up. 
SARAH>> Ashley, the next question is for you: "Is there a tool to help me keep track of the employment networks that I am interested in?" 
ASHLEY>> Yeah, I believe it was going to be mentioned later on in the presentation. The Ticket to Work website can help you to determine what employment networks are in your area, and that can help you to decide. 
SARAH>> Okay, thank you very much. 
Keri, the next question is for you: "What can you do if you're not happy with your EN that you're currently working with?" 
KERI>> So the Ticket to Work program is voluntary. You basically can interview your employment network. So if you choose someone and you're not happy with them, you can do what you call "unassign your ticket" by calling the Ticket to Work program and unassigning it. Then you can choose another employment network or go with vocational rehabilitation. It's your choice; it's voluntary; it's your option. So that's important to know.  
So if you're not happy at any point, you don't have to stick it out and work with something that's not making you happy and not treating you with everything you might need. So again, you just unassign your ticket; and you can go somewhere else and assign your ticket to someone else. 
SARAH>> Thank you very much, Keri. I have another question for you: "Is it possible to have employer-sponsored insurance, Medicare, and Medicaid?" 
KERI>> Yes...so if you opt to have employer-sponsored insurance, you can certainly keep your Medicare and your Medicaid if you qualify for them and if you're in those work incentive phases. Again, you want to look at everything before you do that because there are costs to Medicare; and there are costs to your employer-sponsored insurance. And there could possibly be a monthly cost to the Medicaid as well, depending what type of Medicaid you're on, so it's really something you need to look at and see what covers your needs. 
SARAH>> Thank you. 
Ashley, my next question is for you: "I can't afford to lose my medical coverage when I work. What are my options?" 
ASHLEY>> Again, that's where talking to a benefits counselor in your state is going to come in handy. There are, again, those different work incentives. That Medicare Buy-in Program, for example, you still have the ability to perhaps pay for Medicare if you lose your Medicare, as well as those different Medicaid incentives...so 1619(b), if you're still falling under that threshold, that can help you to keep that Medicaid as well as the Medicaid Buy-in programs for your state. If you still meet those guidelines, then you may be able to work and still maintain the medical insurance. 
SARAH>> Okay, thank you. 
"Is buy-in and spenddown the same thing?" This question is for Keri. 
KERI>> No, the Medicaid Buy-in Program is a different program than Medicaid with a spenddown or a monthly deductible. The Medicaid Buy-in Program actually gives you access to Medicaid, where you might have had a monthly spenddown before.  
For those of you that don't know what a spenddown is, a spenddown is the amount you have to incur out-of-pocket every month before you have access to Medicaid, where the Medicaid Buy-in Program does have higher income and resource limits, so it allows you to access Medicaid right away every month. Again, there might be a monthly premium depending on your state and depending on your income; but it does give you access to that. That's why that Medicaid program is so important. 
SARAH>> Excellent. Keri, another question for you: "Do all employer insurances complement Medicare consistently?" 
KERI>> Medicare would be your secondary insurance. A lot of times it acts the same as employer-sponsored insurance, and that's why you really need to look at your individual case and see what's being covered. It can complement, but sometimes it is just duplicate. 
SARAH>> Okay, great. 
Ashley, I have a question for you: "Can I use work incentives even if I find a job on my own and I don't work with a Ticket to Work service provider like a state VR agency or an EN?" 
ASHLEY>> Yeah, absolutely...the work incentives are available to anybody who receives SSDI or SSI. Enrolling your ticket in the Ticket to Work program is not a requirement to access those work incentives. 
SARAH>> Keri, I have a question for you: "When working, is Medicare the primary insurance in company-provided insurance supplementaries? What happens if coverage is incorrectly addressed? 
KERI>> If you take your employer-sponsored insurance, that is primary; and Medicare becomes secondary insurance. If you have both and you go to the doctor and there's an error versus that, it's really something that has to be addressed at the doctor's office; or sometimes you do have to call your insurance to figure it out because it is so individualized. But your employer-sponsored insurance is primary, so that should be paying the bills first. 
SARAH>> Okay, thank you both for the thorough answers to the questions sent in by our participants. Although we do have more questions for you, which we will address later in the webinar, we're going to stop right here. 
Before we move on, I would like to remind everyone that accessible materials from today's webinar are available either in the Web Links pod or in your confirmation e-mail for today's webinar; or you can always e-mail Ticket to Work at: webinars@choosework.ssa.gov.  
I'm going to go ahead and turn things back over to Keri, who is going to share some information about benefits counseling. 
Thanks, Keri. 
KERI>> Okay, so we're going to talk about benefits counseling that I referred to a few times during my presentation a few minutes ago. 
So what is benefits counseling? 
Through the Ticket to Work program, there is access to benefits counseling...either through the employment networks that might have one on their own or through a program called the Work Incentives Planning and Assistance, or WIPA, program that every state has at least one of. With benefits counseling, we are trained to help you with understanding your Medicare and your Medicaid. Especially if you are working, it's really important to know...are they going to stop, will I have access, when are they going to stop...so you're prepared each step of the way. 
We are trained in work incentives for SSDI, Social Security Disability Insurance, and SSI, Supplemental Security Income. We also are state trained, so that means we have knowledge of Medicare Savings programs, food stamps or SNAP, which is the Supplemental Nutrition Assistance Program. We might also be able to help give you guidelines for fuel assistance and lodging assistance and housing. Housing is really important if you receive subsidized or Section 8. You want to know how that might affect your rent every month. 
So we have a vast knowledge of how all these pieces work together because, again, depending on what you receive, it's really important to know step-by-step what's going to happen, when will it happen; and we can be there to support that through your whole employment journey. 
There are different providers that do benefit counseling. Again, I mentioned this; but it's the Work Incentives Planning and Assistance, or WIPA, projects who are certified through Social Security to provide this information. Your state vocation rehabilitation agencies may have a benefits counselor on staff; and employment networks, including workforce employment networks, might have a benefits counselor on staff or work with benefits counselors. 
So no matter what Ticket to Work agency you work with, you have access to somebody; and, again, if the vocational rehabilitation employment networks don't have someone on staff, every state has at least one Work Incentives Planning and Assistance program. So you can definitely have access to that. 
So what is the WIPA program...again, Work Incentives Planning and Assistance? 
It's a program through Social Security that is free to any beneficiary of SSDI or SSI. So it is not a cost to you. You have access if you are on SSDI or SSI. They are staffed by community work incentives coordinators or CWICs. Again, we are certified through Social Security to provide this information to beneficiaries of Social Security.  
We can provide in-depth counseling. We will sit down with you and go through what your employment goals are. Are you working now, or are you going to be working soon? What income affects your benefits? How will it be affected? When will they be affected?  
So we really do sit down and give you individualized, in-depth counseling and make sure that you understand all the steps during your journey and when things are going to happen; or it's just sometimes knowing that you can pick up the phone or e-mail someone, and we can answer you right back and explain what's happening. If you receive anything from Social Security or your state agency about the benefits that you don't understand or you can be nervous about, we can help you along that journey with most things. 
So who is eligible for WIPA services? 
You have to have been the beneficiary of SSDI or SSI; or if you're not currently receiving SSDI, you have to have SSDI-related Medicare. Again, if you're not receiving SSI, you have to be receiving SSI-related Medicaid, which is the Section 1619(b) Medicaid. 
You have to be working or self-employed. If you're not, you can still call the Ticket to Work Help Line, which there will be information on how to contact them in a few slides. But they can give you generalized information. If you have a job offer pending or you're actively going on interviews, you'll also be priority through the WIPA programs; and we will be able to get in touch with you and work with you. 
If you're a veteran or if you're what they call a transition-aged youth, which is age 14 through 25, and that's even if you're in earliest ages of considering to work. So you don't necessarily have to be working or actively interviewing if you're 14 to 25. But again, if you call the Ticket to Work Help Line, which I will give you the information of how to contact the Help Line, they will give you general information. If you meet these priorities, you'll be referred to the WIPA program that covers your county. 
So why would you want to work with the WIPA program? What can we give you? 
We will help you understand all the work incentives that are available to you. We, again, will help you understand how work will affect your benefits, when that income will affect your benefits, when things might stop. So we'll be able to help you get that informed information so you can make the best decision for you. 
We can also help you with the Ticket to Work program...explaining what it is, if it might be right for you, give you the information to your state vocational rehabilitation vocational rehabilitation and employment networks that cover your area. 
Again, a lot of what we do is dispel the myths that people hear. We always hear those stories of, "My neighbor has this, and this is what happened." You have to know every person gets different benefits; they have different situations. So even though your neighbor's benefits might have stopped, you don't know why or what happened. There are so many different scenarios that really you have to contact a benefits counselor, sit down, and we will go through everything just for you and make sure you know what's going to happen and when it's going to happen.  
So it's really important because there are a lot of myths out there. We always hear those...my medical is going to end and my benefits are going to end; and that's not necessarily true.  
So what is the state vocational rehabilitation, VR, agency? 
They're a state agency that can help people with any disability return to work. They will sit down with you, figure out what your skills are, what your employment goal is, you'll do an employment plan, and they'll be able to guide you into employment...especially if it's the first time you're going back to the workforce. 
VR agencies also can help you get the training you might need to obtain your employment goal, and they can help you with postsecondary education. So if you need to go back to school for a few classes or if you need to obtain an associate's or a certificate, they can help guide you along that journey. 
Now, some states also have separate programs for individuals who are blind or visually impaired. So you want to look into your state to see, if you are blind or visually impaired, if they have a separate program within your VR agency. 
So what are employment networks? 
An employment network, or an EN, is a private or public organization that has signed up with Social Security to provide free employment support to individuals who are eligible for either SSDI or SSI. There are also what they call "workforce employment networks," which are like American Job Centers. So depending on your state, there might be different options available to you. 
So what can ENs and VR agencies provide to you? 
Besides benefits counseling, they will help you with what is your employment goal, what career are you planning. They can sit down and help you explore that. They can help with the job search. So, okay, what are you looking for, what do we need to do? They can help you fill out applications. Especially a lot of applications are online; they can help you guide that. 
VR agencies may also have training programs depending on what your employment goal is and what you are looking to do. You might need a little bit more training; or if it's a different path, you might need to enter a different program.  
There are special programs for veterans and youth in transition, and they can provide ongoing employment support...meaning that they can help you, even once you have that job. They can help answer questions; they can maybe help you if something difficult came up at work; they can help you through that and answer your questions and just work with you. 
They can also provide assistance with requesting job accommodations...what are your rights, what are you allowed to ask for? So depending on what job you end up with depends on the accommodation you may or may not need, but they can help you understand all of that and work with you to request it. 
So where can you go to see who your employment networks or VR agency or workforce agency are? Or there's another agency called the Protection and Advocacy for Beneficiaries of Social Security, or your PABSS...so they can help you. If you come up with a situation, they can help advocate. 
In the Web Links pod underneath your "Employment Team" is a link that brings you to this website that has all the information for your local programs and what's available to you. So that is really important. That website does give you a lot of information, and you can see all your different choices.  
So I talked about this a few times...the Ticket to Work Help Line. It is trained with people that are very knowledgeable in what the Ticket to Work program is, what Work Incentives Planning and Assistance programs are. So they can provide you with general information, or they could refer you to your local WIPA as well.  
For the Ticket to Work program, what they'll do is they'll print out a list of your employment networks, including vocational rehabilitation agencies, and send that to you so you can access any of them and make your choice of what agency might work best for you. 
So the Ticket to Work Help Line is open Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.  The phone number is 1-866-968-7842. Again, it is really important to call the Help Line first, especially for your local WIPA program, because they will refer your information to us; and we can get back to you and work with you. That way, it kind of more guarantees that someone will be in touch with you. 
Okay, so I mentioned the website for Ticket to Work. Now, on this website when you're looking for your agencies that can help provide, there are different choices. The first choice is called a Guided Search. Again, in the Web Links pod under the "Find Help," tool, you can find it under the Ticket to Work Find Help. Again, it's the Ticket to Work Find Help Web link. 
The Guided Search brings you through different options. It will ask you different questions...what you're looking for, what you need; and then it will be able to pop up the agencies that would work for you. 
The other option is the Direct Search. Unlike the Guided Search where it asks you different questions, this is you put in your ZIP code, and it will bring up all the agencies within whatever mile radius you might have chosen and show you all the agencies that are available in your area. Again, there is a Web Links tool. You can find in the Ticket to Work Find Help. 
If you do the Direct Search and put in your ZIP Code, there are other questions. Again, you can do mile radius, what options...are you looking for employment networks, are you looking for WIPA programs? It will pop up anything you are asking for. 
There are some tips that can help you when trying to choose a Ticket to Work service provider...what questions to ask them. Again, you can interview the Ticket to Work agencies...will it work for you...because you want to find an agency that will best fit your needs. You have to be working with them, so you have to be comfortable with who you're working for. 
[Pause] 
Okay, sorry about that. 
Under the Web Links pod, you can find for choosing an employment network. Look for finding an EN and then finding your ticket, and then choosing the right EN for you. Again, those are in the Web Links pod. 
Okay, I'm going to talk about success stories. You can find the link to Amy's story, again, in the Web Links pod under "Success Story, Amy." So Amy has a developmental disability, and she had struggles during school. She faced a lot of challenges figuring out what her path would be; and she persevered through that, and she did let those struggles stop her from pursuing opportunities that would help her succeed once school ended. 
After she finished high school, she started a few college courses; and she did go and find a job as a banker. She also applied and was found eligible for Supplemental Security Income, SSI; but she wanted more from that. She felt underemployed. So she decided to work with her state vocational rehabilitation agency, and that was in Maryland. She was able to work with a counselor to see what her options were to meet her employment goal. 
Now she had that support to help prepare her to become more independent and find employment that would work for her. So they came up with a goal, and she was also able to get guidance on how employment would affect her Social Security disability benefits by working with a benefits counselor; again, that's really important to be able to answer any of your questions...having that support not only for the employment side but the benefit side of being able to work and get your questions answered and that support. 
Once she was working, she was able to work with an employment network through a partnership with VR. So once her VR case was closed, she was able to go work with an employment network to be able to support her in her employment journey. So even though she was employed, she was still able to get that support of somebody who was able to help her with any questions she had. 
Now, through the benefits counselor, she was able to learn about what work incentives were available to her and how was employment going to affect or Social Security benefits, her medical benefits. Because our goal is to support someone so they can succeed in their employment journey, so any questions she might have had, we were able to support that. 
So through the benefits counselor and the work incentive program, she was able to learn about Medicaid while working...again, Section 1619(b) Medicaid continuation. So she was able to know that she would still get medical coverage even if her SSI benefits stopped due to work. And that's really important for a lot of people.  
She also found out about other work incentives, such as if all her benefits stopped she might be able to get back on through something called "expedited reinstatement," where you might not have to do a whole new application; you might be able to get right back on Social Security benefits. So things like that are really important to know, to have that knowledge that if your benefits stop because of work but you need to go back on for any reason, where it might be available to you. 
So with all this support, she was able to feel confident and go about exploring her employment options. She enrolled in the Project Search, which is a school-to-work training program for young adults with developmental disabilities. It's a great program that runs about nine-ten months, and you are able to get internships; and they really do teach you every aspect of becoming employed and being employed. And you're able to get that hands-on experience. 
So through Project Search, Amy worked as an intern at the county's Department of Finance. Now, she found that work to be something she enjoyed; and she was also able to get back to that environment too. Her supervisor said she had a lot of energy, and her work ethic was great. So through that, she was able to get that experience. 
She loved the aspects of it. She learned a lot, and she was able to grow; and she was able to stay there and move up. So through her internship, she got a job and was able to get benefits stopped; and she was able to get a full-time job, and she was able to get that support. So even years later, she is still at the Department of Finance; and she's still evolving there, and she's growing. Again, through that agreement with VR and the employment network, she was able to get what they call "postemployment support." So once you're already employed, you're able to get that support for any questions you might need. 
They were able to work on her soft skills with job coaching. So she had some anxiety. They were able to work with her to reduce that, (inaudible), manage impulses, exercise flexibility, and learn appropriate workplace protocols. So they're able to work with you to learn every aspect that you might need for any questions asked; and they'll be able to help get the tools you need to be able to help with that. 
So they regularly checked in on her and were able to work with her. So through all of these experiences, all of these supports, Amy was able to work her way to financial independence where she no longer received her SSI benefit. She's part of a Union; she receives benefits through her job, some medical benefits through her job. So she had security and stability; but she also knows if anything happens, she has people to look to, to be able to say, "Okay, this is what the next steps are."  
So it really is a success...where she struggled in school, and now she has a full-time job and work benefits and was really ale to grow from that. So through all of these supports available...through the Ticket to Work program, through vocational rehabilitation, through benefits support...she was really able to be confident in her journey. 
SARAH>> All right, Keri, thank you so much.  
We're going to go ahead and pause now and take a few minutes to address some of the questions that we've received from our audience on these topics. Now, because Keri was speaking, most of the questions are going to be towards her.  
But, Ashley, if you have anything through personal experience or any stories or answers that you'd like to contribute, please feel free to chime in, okay? 
The first question we have: "Can you tell me what to expect to continue Medicare coverage after EPMC ends?" 
KERI>> Each state has a protocol for enrolling in Medicare after your EPMC has stopped, so you want to go to your Medicaid agency to...oh, okay, it's Medicare, so you need to call Social Security. I started talking about the programs that might be able to help you with the payments, so I apologize. So you would call Social Security, and they would be able to look into the programs; but there are premiums for Part A and Part B. So you do need to have knowledge of that because it can be costly because you did have premiums through Part A; and now there is a cost to it once that EPMC ends. 
But what I started talking about is that states have programs that might be able to help you pay the premiums if you meet the income and resource limits; and, again, that does vary by state. 
SARAH>> Thank you, Keri. To follow that up: "Is the cost of Medicaid and Medicare set; or if I have an employer-sponsored insurance, will I pay more?" 
KERI>> The Medicare premium is set. Someone might be able to have a lower one; or if you have penalties, you might have a higher premium. But there is a premium set every year for how much Medicare is monthly, or a Medicaid premium that does vary from state to state. They have different guidelines of how much you pay. 
Now, for your employer insurance, some states on Medicaid might say, "Oh, you have employer insurance; we'll lower your premium." But, again, it really does vary state to state; so that's why when I was talking about all the premiums, you really want to sit down with somebody and say, "Okay, this is what's available to you; this is how much you would pay; and these are the discounts you might be able to get." So it really does vary. 
SARAH>> Okay, thank you.  
"You mentioned working with vocational rehabilitation earlier. If I have a VR counselor now, will that person have information on the Ticket program?" 
KERI>> The vocational rehabilitation should have knowledge of the Ticket to Work program. Because VR works a little bit differently sometimes than employment networks, they might not know all of it; but they definitely can get you the information and refer you to where to go to get more information on the Ticket to Work program. Every vocational rehabilitation agency is different in states; so some have more knowledge than others, but it doesn't hurt to ask. If they don't know the answer, they will help you get that answer. 
SARAH>> Okay, thank you. 
Ashley, we do have a question for you: "How do I find information about employment networks that provide services in my area?" 
ASHLEY>> Again, if you refer back to that Ticket to Work "Help Tool" link in the Web Links tool, you can go on there type in your ZIP code or answer certain questions depending on what you're looking for, for services because each network is going to provide different services. And that can help you to find the employment networks in your area that can serve you. 
SARAH>> Keri, the next question is for you: "How do I connect with a service provider? Is there a way to find a specific type of service provider, such as a state VR agency or an EN?" 
KERI>> Sure, again, so if you go to that link in the Web Links pod of "Finding an EN," or "Meet Your [Employment] Team," those links will both bring you to the website where you can do the searches and see what agencies are in our area and who might be best to help you. 
SARAH>> Okay, great, thank you. And then next month's webinar, "Choosing a Service Provider That's Right for you," is on October 23rd and will be covering that exact topic. So we look forward to having you for that. 
Keri, I have another question for you: "Could I be eligible for Medicare as well as Medicaid now if I currently meet the requirements for SSI and Medicaid?" 
KERI>> To be eligible for Medicare, you have to be on SSDI for 24 months. So if you meet that requirement, then you're eligible for Medicare. Medicaid...every state has different income and resource or asset limits; and, again, depending if you're SSDI or SSI will depend on if you're eligible for the Medicaid. So you want to refer to your state Medicaid agency for the eligibility for the program. 
SARAH>> Thank you, Keri. 
"If the employer's insurance is primary and Medicare is secondary, is Medicaid third?" 
KERI>> Yes...so Medicaid is always the payer of last resort. So no matter how many insurances you have, Medicaid always pays last. So if you have employer-sponsored insurance, that's first; Medicare would be second; and then Medicaid would be third. 
SARAH>> Keri: "How can I find out if I'm using any work incentives?" 
KERI>> I'm going to refer you to your WIPA program in your state that serves your area because they can help you find out that information. You can also call Social Security and ask that information if you don't want to work with somebody; but if you work with the WIPA, they're able to explain what those work incentives are and what that means because there isn't a way for us to find out what work incentives you have used or might be available to you if you haven't started using them yet. 
SARAH>> Ashley, I have a question for you: "I'm interested in participating in the Ticket program. How do I get started?" 
ASHLEY>> A good way to get started would be to use that Ticket to Work Help tool. Again, it's in the Web Links box. That will help you to find the networks that are using the Ticket to Work program and who can provide you the services that the Ticket to Work program provides. Another way, you can refer to the Ticket to Work Help Line by calling them and getting in touch with somebody that way as well. 
SARAH>> Keri, this one is back to you: "Will a CWIC or benefits counselor be able to tell me all of the work incentives that I'm eligible for?" 
KERI>> Yes...so that's one of our main things that we do. We're able to sit down, we'll find out what benefits you have, and we'll go through every work incentive that's available to you whether you are waged employment or self-employed. There are different work incentives depending on what benefits you get and what your employment goal is, but we can definitely sit down and go through every one that's available to you. 
SARAH>> Thank you, Keri. The next question we have for you is: "If I'm working with an EN that doesn't have a certified benefits counselor on staff, do I have to unassign my ticket with the EN to work with my local WIPA to receive benefits counsel?" 
KERI>> No, so we are a separate program. You can work with any employment network or VR in your state that you choose to; and if they don't have a certified benefits counselor, you can work with your WIPA program in your area without a problem. 
SARAH>> Keri, another question for you: "I'll be starting to work soon and have worked with a CWIC to learn more about my benefits and work incentives, but I think I'll need additional services and support to transition to the workplace. Can my CWIC help me to connect with an EN?" 
KERI>> We can't help you choose the specific EN you're working with, but we can definitely get you the information of the local ENs that work in your area and the local VR and go through what options you have and what might be the best fit. We can't directly help you choose one, but we can definitely give you the tools for you to choose one. 
SARAH>> Thank you, Keri. 
Ashley, I have a question for you: "Do I need to pay anything to participate in the Ticket program?" 
ASHLEY>> No, the Ticket to Work program is completely free. As long as you're a beneficiary of SSDI or SSI, those services are there for you to use as you wish and at no charge. 
SARAH>> Ashley, another question for you: "Can a service provider help me with the accommodation request process?" 
ASHLEY>> If you are talking to a service provider, like an EN network or VR services, yes, they can help you navigate that process, help you understand what is an accommodation and what sort of accommodations are you eligible for and how to approach your employer about those accommodations. 
SARAH>> Ashley, I have one more question for you: "Do I need to have the paper ticket sent to me by Social Security in order to participate in the program?" 
ASHLEY>> No, there was at one point in time a real paper ticket that was sent to individuals; but that is no longer a thing. It's just simply a matter of wording at this point that people use, but you don't actually have to have a physical piece of paper saying that you have the Ticket to Work program or anything. 
SARAH>> Okay, thank you again for being with us today, Keri and Ashley.  
It is time to move on; but before we do, I would like to remind everyone that the accessible materials from today's webinar are available either in the Web Links pod or in your confirmation e-mail for today's webinar or my e-mailing Ticket to Work at webinars@choosework.ssa.gov.  
We are out of time for questions, as I said, for today's webinar. Thank you for sending in all of your questions. We hopefully provided answers to your questions on the Ticket program. 
Social Security's Ticket to Work program has a number of service providers and other resources ready to help you get started. To get a list of providers in your area or to get answers to questions that you may have about the Ticket program and other work incentives, you can contact the Ticket to Work Help Line at 1-866-968-7842 or, for TTY, 1-866-833-2967, Monday through Friday, from 8:00 a.m. to 8:00 p.m. Eastern Time.  
Or you can visit the Ticket to Work website at: choosework.ssa.gov at any time. You can also find us on social media or subscribe to the blog and e-mail updates by visiting choosework.ssa.gov/contact. This link appears on the Web Links pod under "Ticket to Work Contact Information." 
Please join us for our next WISE webinar in this Putting It Together series, "Choosing a Service Provider That's Right for You." This will be held on Wednesday, October 23, 2019, from 3:00 p.m. to 4:30 p.m. Eastern Time. Registration is open, and we look forward to having you attend. To register online, go to: choosework.ssa.gov/WISE; and you can call 1-866-968-7842 or, for TTY, 1-866-833-2967. 
Your feedback is very important to us. It helps us plan future webinars. Please provide your feedback and tell us what you think about today's webinar by taking our survey. To take the survey, you can follow the link that will pop up after the webinar or visit the Ticket to Work website to complete the survey.