I can’t believe I am just learning about the Social Security SSI Threshold for Medicaid benefits!

For the past 16 years, my understanding was that to get Medicaid through SSI, you needed to qualify for a monthly SSI payment.

That is NOT true, and here’s the proof on the Social Security website.

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.
To qualify for continuing Medicaid coverage, a person must:

• Have been eligible for an SSI cash payment for at least 1 month;
• Still meet the disability requirement; and
• Still meet all other non-disability SSI requirements; and
• Need Medicaid benefits to continue to wminork; and
• Have gross earnings that are insufficient to replace SSI, Medicaid and publicly funded attendant care services.

This means that SSI beneficiaries who have earnings too high for a SSI cash payment may be eligible for Medicaid 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.

This threshold is based on the:

• amount of earnings which would cause SSI cash payments to stop in the person’s State; and
• average Medicaid expenses in that State.

If a SSI beneficiary has gross earnings higher than the threshold amount for his/her State, SSA can figure an individual threshold amount if that person has:

• Impairment-related work expenses; or
• Blind work expenses; or
• A plan to achieve self-support; or
• Personal attendant whose fees are publicly funded; or
• Medical expenses above the average State amount.

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2017 1619(b) THRESHOLD AMOUNTS FOR DISABLED SSI BENEFICIARIES

STATE	THRESHOLD
TEXAS	$34,821

In layman’s terms, this means that even if you earn too much money to receive an SSI payment, you can continue to get Medicaid while earning up to $34,821 (or more if you ask for an individual threshold of more than $34,821).