Work Incentives Wednesdays: Medicaid While Working

What would you do if you had a great opportunity for a dream job but thought that you would lose your Medicaid coverage if you went to work? Would you take the job or let it pass?

We have good news! In this month's Work Incentives Wednesdays, we share how people who receive Supplemental Security Income (SSI) based on a disability, can keep their Medicaid while they are working, even if they earn enough income to no longer receive an SSI cash payment. With this Work Incentive, "Medicaid While Working," you can pursue career goals with the support you need.

What is Medicaid While Working?

Section 1619(b) of the Social Security Act, commonly called "Medicaid While Working", is a valuable safety net that continues Medicaid coverage while you are still eligible for SSI, even if you are not receiving a monthly cash payment. If you're eligible for Medicaid under 1619(b), your SSI cash benefit can restart without a new application if you stop working or if your earnings are reduced. To use this Work Incentive, you must meet 5 requirements:

• Have been eligible for an SSI cash payment for at least 1 month; and
• Still meet the disability requirement; and
• Still meet all other non-disability SSI requirements; and
• Need Medicaid benefits to continue to work; and
• Have gross earnings that are insufficient to replace SSI, Medicaid and publicly funded attendant care services.

Threshold amounts

Social Security uses a state threshold amount to determine eligibility for Medicaid While Working. Each state has a different threshold amount, including different threshold amounts for people who are blind. The threshold amount is calculated based on the values of SSI cash benefits, Medicaid benefits and publicly funded personal or attendant care benefits. Social Security's Red Book can help you find your state's threshold amount.

Even if you earn more than your state's threshold amount, you can still be eligible for Medicaid While Working if you have:

• Impairment-Related Work Expenses
• Blind Work Expenses
• A Plan to Achieve Self-Support
• Publicly funded personal attendant expenses
• Medical expenses above your state's average amount

Are there any other ways to keep Medicaid coverage?

If you don't qualify for 1619(b), you can also find out if your state offers "Medicaid Buy-In." Through the buy-in, you can pay a monthly premium to keep your Medicaid coverage. You may qualify if you:

• Meet Social Security's definition of having a disability
• Would be eligible for SSI if you earned less income

If you do not receive SSI benefits, your state will decide if you meet disability requirements without considering whether you work. You can get more information from your state's Medical Assistance office. Call 800-MEDICARE or 877-486-2048 (TTY) for your state's buy-in program.

1619(b) and Other Work Incentives

As you consider work, search for a job and transition to the workplace, Medicaid While Working and other Work Incentives can give you the support you need to find financial independence. Learn about other Work Incentives in our Work Incentives Wednesdays blog series.