Do SSI and Medicaid benefits stop when I return to work?

In many states, if you receive Supplemental Security Income (SSI), you are automatically eligible for Medicaid, the government health care program for low-income people. These benefits can be a crucial lifeline, medically and financially, if you become unable to work due to illness or injury. If you are able to return to work, your SSI payments may stop due to your income, but that may not mean losing Medicaid.

That’s thanks to a program called Medicaid While Working, one of many work incentives offered by the Social Security Administration (SSA) to help people with disabilities reenter the workforce. These policies allow some beneficiaries to test the labor waters without immediately losing their benefits.

How Income Affects SSI

Social Security administers SSI, a safety net for the elderly, blind, and disabled with limited financial means. To qualify, your “book income” cannot exceed a strict cap set by the federal government and adjusted annually for inflation. In 2022, the federal limit is $841 per month for an individual and $1,261 per month for a married couple. (Maximums may vary by state, as most states offer additional payments to top up federal SSI benefits.)

Book income includes a portion of your earnings from work as well as money from other sources, such as investments, government benefits, and cash assistance from friends or family. Social Security may approve your application for SSI if your income is below the ceiling, but if it subsequently exceeds the limit, you are no longer eligible for monthly SSI payments.

However, even in this situation, the Medicaid coverage that began as a result of your obtaining SSI may continue if you meet these criteria.

  • You were eligible for SSI for at least one month.
  • You still have the same medical condition that qualified you for SSI in the first place.
  • You meet all of the SSI eligibility requirements apart from those relating to income.
  • You need Medicaid coverage to work.
  • Your gross earnings from work are not enough to replace your SSI, Medicaid, and any government-funded personal or attendant care (for example, work assistance or paid home care services) that you would no longer receive.

Understanding the Medicaid Threshold Amount

To determine if someone is earning enough to replace their SSI and Medicaid benefits, the SSA uses a figure called the “threshold amount,” which is calculated from the average Medicaid spending in that state and the amount of income that would end the payments. in cash from the SSI there.

Since both of these numbers vary by state, a threshold amount that ends your Medicaid coverage in one part of the country may not in another. For example, a person in Alabama who received SSI due to disability but lost it due to income could earn up to $34,521 a year and still retain Medicaid, but a similarly California could earn up to $54,082 without losing Medicaid.

Maria D. Ervin