SSI Work Incentive - 1619(b)

If you earned more than $800 (In 2003) in gross wages...

The IDHS Policy Manual 06-06-02 has the rules for 1619 Medicaid, under the section titled "Qualified Severely Impaired Individuals." Disabled SSI recipients who earn more than $800 or who lose their SSI because of wages are probably 1619 eligible.

The 1619(b) incentive provides continued Medicaid coverage for SSI recipients when their earnings become too high to allow an SSI cash payment.

To qualify for this incentive, a person must:

• Have been eligible for an SSI cash payment for at least one month;
• Still meet the disability and non-disability requirements;
• Need Medicaid in order to work; and
• If you earned more than $780 (IN 2002) in gross wages, or lose SSI because of wages, then you may be eligible for FREE MEDICAID.

Substantial Gainful Activity Level Increases to $800 January 1, 2003 (SSA News Release)

Under the new rules, based on the average wage, we will adjust annually the substantial gainful activity amount for people with impairments other than blindness. Beginning January 1, 2003, the guideline will be $800.

Trial Work Period increases to $570 January 1, 2003

Under the new rules, we are increasing this monthly amount from $200 to $530 beginning January 1, 2001. On January 1, 2002 the amount increased to $560 per month. For future years, we will adjust the amount based on increases in the average wage. The amount increased to $570 per month on January 1, 2003.

Student earned income exclusion increases to $1,340 a month with an annual limit of $5,410.

Under the new rules, we are raising the amount of earned income that may be excluded to $1,340 a month with an annual limit of $5,410. For future years, we will adjust the amount based on increases in the cost-of-living.

What Is Timely Progress?

• For the first 24 months that you are using your ticket, there is no work requirement. You just have to do whatever your IWP or IPE says you should be doing to prepare yourself for work.
• After 24 months, in the next 12 months (months 25 - 36) you have to have gross earnings in 3 months at a level that is over the Substantial Gainful Activity (SGA) level ($800/month is 2003).

What Is Timely Progress?

• For the first 24 months that you are using your ticket, there is no work requirement. You just have to do whatever your IWP or IPE says you should be doing to prepare yourself for work.

Is There Anything Else I Need to Know?

There are many details that are not included in this fact sheet. You can contact Maximus, an Employment Network, or Health and Disability Advocates for more information.

Health and Disability Advocates 312-223-9600 v; 800-427-0766 tty.

Other Work Incentive Changes

The monthly SGA amount for statutorily blind beneficiaries increases to $1,330 for 2003. AND---Changes based on the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA)

WHEN YOU GET A JOB

If receiving SSDI

• Keep track of Trial Work Period (TWP) Months (any amount earned over $530 in the month in 2001, $560 in 2002 and $570 in 2003)
• Allow for 3 months grace period during which continuing disability review is completed
• Return checks not due you to the SSA office B get a receipt
• Keep track of Extended Period of Eligibility, if income falls below $800 (in 2003) during 36 month EPE, notify SSA that a check is due.

Medicare coverage will continue at least 93 months after the TWP for a total of at least 8 and 1/2 years including TWP months. This is an additional 4 1/2 years as of 10/1/2000.

• Keep track of 1619a eligibility, if not eligible for benefit check due to income from work or if earning over $800 (in 2003) a month, eligible for Medicaid without a spenddown B verify eligibility with SSA and Public Aid
• Keep track of 1619b eligibility B if earning less than $26,001 annually (in 2002/3) B eligible for Medicaid without a spenddown.

Here's What To Do

1. Take your paycheck stubs to your local Social Security (SSA) office. You must take your paycheck stubs to your SSA office by the 10th of every month, or mail them in by the 1st of every month to keep your Medicaid without a spenddown.
2. Ask the SSA worker to make sure that all the information has been received to make a 1619 decision on your case.
3. SSA will consider your gross earnings and how much you use Medicaid, and will make a 1619 decision.
4. If you meet the requirements for 1619, ask for proof of your 1619 status and take that and this flyer to your case worker at the Department of Human Services. Ask for 1619 Medicaid.

You can get an application from the AIDS Legal Council of Chicago, from Health and Disability Advocates, or by calling 800-226-0768.

For Department of Human Services Case Workers

The IDHS Policy Manual 06-06-02 has the rules for 1619 Medicaid, under the section titled "Qualified Severely Impaired Individuals." Disabled SSI recipients who earn more than $780 or who lose their SSI because of wages are probably 1619 eligible.

To verify that someone is eligible for continued Medicaid without a spenddown, check the monthly list of Section 1619 cases called "OBRA Section 1619 Cases." If the client is not on the monthly list, you must send them a notice asking them to provide proof of their 1619 status before terminating their Medicaid.

Reprinted with Permission.

Health & Disability Advocates
For A Responsible Safety Net
Security with Dignity for Low Income Elderly and Disabled

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