One of the biggest fears about working while on SSI is losing Medicaid. Section 1619(b) was designed to eliminate that fear by letting you keep Medicaid even when your earnings are too high for SSI cash payments.
In this article, we'll cover:
- What 1619(b) is
- How to qualify
- State threshold amounts
- How it protects you
1. What 1619(b) Is
The protection:
- Keep Medicaid coverage while working
- Even if SSI cash payment stops due to earnings
- Continues as long as you meet requirements
- Critical protection for working disabled individuals
Why it exists:
- Fear of losing healthcare prevents work
- Medicaid is essential for many with disabilities
- 1619(b) removes this barrier
- Encourages work without healthcare risk
How it works:
- You work and earn money
- Earnings eventually stop SSI cash payment
- But Medicaid continues under 1619(b)
- As long as you meet requirements
2. How to Qualify
Requirements:
- Were eligible for SSI cash payment for at least one month
- Still disabled (meet SSI disability criteria)
- Still meet all non-disability SSI requirements
- Need Medicaid to work
- Can't afford equivalent healthcare
- Earnings under state threshold
"Need Medicaid to work":
- Use Medicaid services
- Would need medical care to continue working
- Medicaid enables your employment
- Most working disabled people qualify
"Can't afford equivalent coverage":
- Couldn't buy similar coverage
- At reasonable cost
- Without undue hardship
- Generally easy to meet
What could end 1619(b):
- Medical improvement (no longer disabled)
- Earnings exceed state threshold
- Resources exceed $2,000
- Fail to meet other SSI requirements
Important: You must still meet SSI's resource limit ($2,000) to maintain 1619(b) status, even if you don't receive cash SSI.
3. State Threshold Amounts
What the threshold is:
- Each state has earnings limit for 1619(b)
- Earn under this = keep Medicaid
- Earn over this = 1619(b) may end
- Varies significantly by state
High threshold states (examples):
- Connecticut: $75,000+
- Alaska: $60,000+
- Massachusetts: $55,000+
- Higher cost of living areas
Lower threshold states (examples):
- Some Southern states: $30,000-$40,000
- Varies year to year
- Check current year amounts
- ssa.gov has updated list
Finding your state's threshold:
- SSA publishes annually
- Search "1619(b) threshold" + your state
- Or call SSA
- Changes each year
4. How It Protects You
Healthcare continuity:
- Medications continue
- Doctor visits covered
- Hospital care if needed
- No gap in coverage
Work without fear:
- Know healthcare is protected
- Focus on your job
- Build skills and income
- Progress toward independence
Path to other coverage:
- While on 1619(b), may eventually get employer insurance
- Medicare if on SSDI too
- Marketplace coverage
- Transition when ready
If work stops:
- Can return to SSI cash payments
- If you become unable to work
- No waiting period
- 1619(a) provides this protection
1619(a) vs. 1619(b)
1619(a):
- Cash SSI continues despite earnings
- When earnings are moderate
- SSI payment reduced but not eliminated
- Medicaid continues automatically
1619(b):
- Cash SSI has stopped due to earnings
- But Medicaid continues
- Higher earnings than 1619(a)
- Special protection
Progression:
- Start on SSI
- Work and enter 1619(a) (reduced SSI)
- Earn more, enter 1619(b) (no cash SSI, keep Medicaid)
- Eventually may not need Medicaid
Maintaining 1619(b)
What to do:
- Keep working
- Stay under state threshold
- Maintain resources under $2,000
- Report changes to SSA
Report to SSA:
- You're working
- That you want 1619(b) status
- Any changes in situation
- Don't assume automatic
Watch your resources:
- $2,000 limit still applies
- Even without cash SSI
- Use ABLE account for excess
- Track carefully
How Purple Helps
Purple supports your work journey:
- Track earnings and resources
- Stay under $2,000 resource limit
- ABLE account integration
- Clear financial picture
- Support your 1619(b) status