However, the Ticket to Work program provides flexibility and support so beneficiaries can make the transition into the workforce while maintaining their benefits.

How Working Affects Your Medicare Benefits

SSI disability recipients who receive Medicaid benefits is granted this benefit from the State of where he/she resides. Medicaid is classified as a "Needs Based" health insurance program (also called Medical Assistance, or MA) for people with low income or those who have low employment work credits that has not accumulated to receive SSDI. In Michigan, there is traditional Medicaid (TM) and the Healthy Michigan Plan (HMP). HMP started in 2014 as part of the Affordable Care Act. Once you are enrolled, TM and HMP work just like other health insurance. With Medicaid, for some people will be automatically renewed by an MDHHS process that checks eligibility information automatically using shared government records on a monthly basis and ANY source of income or liquid assets (personal property that can be transferred into cash) can affect eligibility.

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Under the Ticket to Work program, when an individual who receives SSI cash and medical benefits and starts working, their earnings can affect their monthly cash benefit, their medical insurance, food stamps and other ancillary programs they are receiving. This is where an EN can assist the beneficiary in keeping his/her benefits under this program through "Benefits Planning."

 

Will I Lose My Medicaid Benefits?

Medicaid is typically unavailable to disabled workers who have a certain level of earnings that is over the eligibility requirement. However, qualified workers with severe disabilities can continue to receive Medicaid benefits through a program called the 1619b Social Security Act. Since 1987, Section 1619(b) of the Social Security Act has provided one of the most powerful work incentives currently available for Supplemental Security Income (SSI) recipients. Section 1619(b) provides continued Medicaid eligibility for SSI recipients whose earned income is too high to qualify for SSI cash payments, but not high enough to compensate for the loss of Medicaid coverage. Individuals who are eligible for Section 1619(b) don’t receive SSI payments because their countable income is over the break-even point (BEP-countable incomes equals over their SSI cash benefits) after Social Security has applied all applicable income exclusions and deductions. There is no time limit regarding 1619(b); a person can continue to use it as long as they continue to meet the eligibility criteria.

 

To qualify for continuing Medicaid coverage, a person must:

• Eligible individuals must continue to meet the Social Security disability requirement.

• Individuals must have been eligible for a regular SSI cash payment based on disability for a previous month within the current period of eligibility.

• Eligible individuals must continue to meet all other non-disability SSI requirements.

1. Eligible individuals must need Medicaid benefits to continue working.
   Social Security determines this “need” by applying something called the “Medicaid Use Test.” This “test” has three parts; a person only needs to meet one of the parts to pass. An individual depends on Medicaid coverage if he or she:​

•  Used Medicaid coverage within the past 12 months; or

•  Expects to use Medicaid coverage in the next 12 months; or

•  Would be unable to pay unexpected medical bills in the next 12 months without Medicaid coverage

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This means that SSI beneficiaries who receive earnings too high for a SSI cash payment may be eligible for the 1619b Social Security Act if they meet the above requirements. SSA uses a threshold amount to measure whether a person’s earnings are high enough to replace his/her SSI and Medicaid benefits. To determine the maximum earnings you can make under the 1619b program, use this link to find your state's maximum yearly threshold earnings: https://www.ssa.gov/disabilityresearch/wi/1619b.htm.

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If your annual earnings are above the threshold for your particular state, then the next option is called Medicaid Buy-In through the Ticket to Work and Work Incentives Improvement Act (TWWIIA), which establishes a Medicaid Buy-In option at the state level. The premium is prorated according to the individual's annual gross earnings. Currently, 46 states participate in the Medicaid Buy-In program.

 

What If I Get Insurance Through My Job?

If you return to full-time employment and qualify for private, employer-sponsored health insurance, you won’t necessarily lose your Medicare benefits. If you remain eligible for both forms of coverage, Medicare can be added as a secondary payer to your employer-provided insurance. To find out if you are eligible to keep both insurances, contact the company's HR benefit department or contact Medicare for additional information using this number: 1-800-Medicare.

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However, for Medicaid, if you are offered employer-sponsored health insurance, you may be able to keep both. To find out, you can contact the company's HR benefit department or contact Medicare for additional information using this number: 1-800-Medicare.

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Let Us Help You Understand and Protect Your Disability Benefits

The employment professionals at Abbott & Associates Financial Services, LLC have been helping people return to work without risking their cash benefits for over 10 years. If you want to work but don’t know where to start, fill out our online contact form or call (734) 363-2641 to complete a quick intake with one of our team members.

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Benefits of Participating in the Ticket to Work Program For Medicaid Recipients

• You will continue to receive your Medicaid coverage under the 1619b Social Security Act once your cash benefits are exhausted.

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For additional information-Videos

 "How Will Work Affect My Medicaid/Medicare Insurance" click on the link: 

"Work & Medicaid/Medicare"

 

Our Employment Professionals Help Every Step of the Way. If you’re afraid of returning to work and losing your disability benefits, the dedicated employment professionals at Abbott & Associates Financial Services, LLC. can help. We can guide you through the requirements of the Ticket to Work program and give you the tools you need to reach your full working potential. Please fill out our online contact form or call (734) 363-2641 to complete a quick intake with one of our team members.