1619(a) and 1619(b)

1619(a)

1619(a) allows SSI recipients to continue receiving SSI cash payments even when earnings exceed the SGA level ($1,000/month for non-blind and $1,640/month for blind - 2011). As earnings increase, SSI cash payments decrease until earnings completely replace cash benefits; there is no effect on Medicaid coverage.

1619(b)

Medicaid While Working — Section 1619(b) (SSI eligible)
One of the biggest concerns SSI beneficiaries have about going to work is the possibility of losing Medicaid coverage.  Section 1619(b) of the Social Security Act provides some protection for these beneficiaries.

How does it help you?After you return to work, 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.
How do you qualify?To qualify, you must meet all of the following qualifications:

  • Have been eligible for an SSI cash payment for at least 1 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. (See following “threshold amount” discussion.)
 The “threshold amount” is the measure that we use 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 cash payments to stop in your state; and
  • The annual per capita Medicaid expenditure for your state.
If your gross earnings are higher than the threshold amount for your state (see chart below), you may still be eligible if you have:



State Threshold Amounts
for Disabled SSI Beneficiaries

2011 

STATETHRESHOLD STATETHRESHOLD
Alabama$24,438 Montana$29,429
Alaska$51,125 Nebraska$36,295
Arizona$30,870 Nevada$30,135
Arkansas$28,730 New Hampshire$40,720
California$35,023 New Jersey$33,487
Colorado$31,990 New Mexico$36,421
Connecticut$56,502 New York$45,454
Delaware$38,668 North Carolina$33,568
District of Columbia$45,037 North Dakota$38,049
Florida$28,753 Ohio$34,013
Georgia$27,509 Oklahoma$26,480
Hawaii$36,977 Oregon$31,462
Idaho$38,495 Pennsylvania$29,410
Illinois$26,141 Rhode Island$36,324
Indiana$34,713 South Carolina$28,141
Iowa$30,811 South Dakota$32,991
Kansas$34,071 Tennessee$26,645
Kentucky$27,345 Texas$29,329
Louisiana$29,763 Utah$29,176
Maine$32,403 Vermont$35,554
Maryland$38,660 Virginia$32,545
Massachusetts$36,391 Washington$28,160
Michigan$29,036 West Virginia$28,283
Minnesota$49,550 Wisconsin$31,468
Mississippi$25,923 Wyoming$33,855
Missouri$31,180 N. Mariana Islands$17,196

 

 

Do all States use the same Medicaid eligibility rules?Most States use our SSI eligibility rules to determine Medicaid eligibility. However, the following States use their own eligibility rules for Medicaid that are different from our SSI eligibility rules:

ConnecticutMinnesotaOhio
HawaiiMissouriOklahoma
IllinoisNew HampshireVirginia
IndianaNorth Dakota 

If you live in one of these States, you will continue to be eligible for Medicaid under section 1619(a) or (b) if you were eligible for Medicaid in the month before you became eligible for section 1619.

 

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