Medicare and Medicaid Employment Supports

If you or someone you know receives Social Security benefits (SSDI or SSI) due to a disability, returning to work comes with a list of questions, especially about how working will affect your benefits. Talking with a certified Benefits Counselor can help you find the answers you need. But there are also resources you can use to do your own research. Today, we'll discuss some Social Security Work Incentives that may apply to you and point you to additional sources of information to help you understand your Medicare and Medicaid options.

Social Security Work Incentives

Work Incentives help eligible individuals as they pursue financial independence through work.

Special rules make it possible for people with disabilities receiving Social Security or Supplemental Security Income (SSI) to work and still receive monthly payments and Medicare or Medicaid.

Further details are provided on the Social Security website.

Supports for people who receive SSDI and Medicare

1. Continuation of Medicare Coverage

Your Medicare coverage continues while you are working as long as you are receiving SSDI benefit payments. When you reach a point that your SSDI benefits stop because of your earnings, you may be pleased to learn that most people can keep their Medicare coverage for at least 93 consecutive months (7 years and 9 months) after the end of their Trial Work Period. You do not pay a premium for Part A (Hospital Insurance) of Medicare. If you are already enrolled in Medicare Part B (Supplemental Medical Insurance) or Part D (Prescription Drug Coverage), your coverage will continue, though it is not premium-free.

2. Medicare for Persons with Disabilities Who Work

Once your premium-free Medicare coverage ends because of your work and earnings, you can buy continued Medicare coverage if you continue to be medically disabled and you're under the age of 65. If you have limited income and resources, you may be eligible for state assistance to afford the premiums.

For "Medicare for Persons with Disabilities Who Work," you can buy Part A separately from Part B, but you cannot buy Part B unless you also buy Part A. Part D coverage is available to anyone who is entitled to Part A and/or enrolled in Part B.

Supports for people who receive SSI and Medicaid

3. Medicaid While Working – Section 1619(b)

After you start working, your Medicaid coverage can continue, even if your earnings (alone or in combination with your other income) become too high for an SSI cash payment.

You must meet all of the following qualifications:

• Were eligible for an SSI cash payment for at least one month;
• Would be eligible for cash payment except for earnings;
• Still be disabled;
• Still meet all other eligibility rules, including the resources test;
• Need Medicaid in order to work; and
• Have gross earned income that is insufficient to replace SSI, Medicaid, and any publicly funded attendant care.

Social Security uses a "threshold amount" to decide whether your earnings are high enough to replace your SSI and Medicaid benefits. Your threshold amount is based on:

• The amount of earnings that would cause your SSI payments to stop in your state; and
• The average annual per capita Medicaid expenditure for your state.

Even if your gross earnings are higher than your state's threshold amount, you may still be eligible for Medicaid While Working. Social Security will figure your individual threshold if you have:

• Impairment-Related Work Expenses
• Blind Work Expenses
• A Plan to Achieve Self-Support
• Publicly funded attendant or personal care
• Medical expenses above the state per capita amount

Learn more

To find out more about these Work Incentives, pricing information for buying Medicare coverage and eligibility requirements for price reductions and state assistance, threshold amounts for Medicaid While Working in your state, and other supports, please visit the Social Security Red Book.

You can also join us for the next WISE webinar! On September 25, we'll discuss these Work Incentives and how working with a Ticket to Work service provider can help you on the path to financial independence through Work. Register now!

Additional resources to help you find information about Medicare and Medicaid:

• Medicare.Gov
• Medicaid.Gov
• The U.S. Department of Labor's Medicaid "Buy-in" Q&A
• Medicare Savings Programs

Ticket to Work

Social Security's Ticket to Work (Ticket) program supports career development for people ages 18 through 64 who receive Social Security disability benefits (SSI or SSDI) and want to work. The Ticket program is free and voluntary. Ticket program service providers, like Employment Networks and State Vocational Rehabilitation agencies, can offer you the services and supports you need to succeed on the path to financial independence through work.

To learn more about the Ticket program, visit choosework.ssa.gov. You can also call the Ticket to Work Help Line at 1-866-968-7842 or 1-866-833-2967 (TTY) Monday through Friday, 8 a.m. to 8 p.m. ET. Ask a representative to send you a list of service providers or find providers on your own with the Ticket program Find Help tool.