Medicaid and Work Incentives for
Social Security Disability Beneficiaries
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Spotlight on Social Security
Medicaid and Work Incentives for
Social Security Disability Beneficiaries
If you are working or thinking about working while receiving Supplemental Security Income (SSI) benefits, you might wonder what happens to your health coverage. The good news is that you can often keep your Medicaid (Medi-Cal in California) even if your SSI payments stop. These resources will help you understand how that works and what tools can help you stay covered while you work toward your employment goals.
Programs and Support:
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Medi-Cal: California’s version of the Federal Medicaid Program. It is available for specific groups with low income, such as children, pregnant women, seniors, and people with disabilities.
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Section 209(b) States: States have more restrictive Medicaid eligibility rules than the federal SSI standards. If you move to one of these states, you may need to meet additional requirements to keep Medicaid. California is not a 209(b) state, so SSI recipients automatically qualify for Medi-Cal.
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1619(b): A rule that allows you to keep your Medi-Cal while working, even if your SSI payments stop because of your earnings. You can move between receiving SSI payments and Medicaid-only status without needing to reapply each time. That way, you don’t have to choose between working and losing your health coverage. Visit the Social Security Administration (SSA) website to find the 1619(b) Info and Earnings Threshold Chart.
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1619(b) Eligibility Criteria- Still meet the SSI disability or blindness criteria, keep unearned income and resources within SSI limits, and have received SSI or been eligible for 1619(b) in the past year.
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Individualized Thresholds: If your earnings are higher than the standard 1619(b) limit, you might still qualify for Medi-Cal through a special calculation. This includes: Your actual Medi-Cal expenses, Impairment-Related Work Expenses (IRWEs), Blind Work Expenses (BWEs), Money in a PASS (Plan to Achieve Self-Support), and publicly funded attendant care. These thresholds help people with higher medical costs or certain expenses stay covered. To learn more about how Social Security calculates the threshold amounts, check the Social Security website.
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Medicaid Buy-In (MBI) Program: If you earn too much for 1619(b), you may qualify for Medi-Cal through this program. In California this program is known as the Medi-Cal Working Disabled Program. This program has no premium, and you can earn more at work while keeping your health coverage. Learn more on the California Disability Benefits 101 (DB101) website.
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MBI Program Eligibility Criteria: Includes age range (18–64), income and resource limits (up to 250% of the Federal Poverty Level), and earnings above SGA do not disqualify you.
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Practical Steps:
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Use Online Tools: Visit the Disability Benefits 101 website to see if you qualify for Medi-Cal while working. You can use the Countable Income Tool or the Medi-Cal for the Working Disabled Estimator tool.
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Know Your Options: If your earnings are too high for standard 1619(b), contact your local county Social Services Agency to ask about Individualized Thresholds or Medi-Cal Buy-In programs. Find your local office on the Department of Health Care Services website.
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Need additional support? The Health Consumer Alliance (HCA) is a statewide partnership that offers Free Over the Phone or In-Person Assistance to help California residents struggling to get or maintain health coverage and resolve problems with their plans. Visit the Health Consumer Alliance website to learn more.
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Stay informed and keep records: Keep copies of all SSA or Medi‑Cal letters and notify agencies about changes in your work or income.
Key Takeaways:
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Medi-Cal (Medicaid) provides health care for people with low income, and California SSI recipients automatically receive Medi-Cal.
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You can work and keep your Medi-Cal through programs like 1619(b) or Medi-Cal Buy-In.
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Even if your SSI stops, your health coverage does not have to.
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Use online tools and resources to understand your options, such as if your income or resources exceed certain program income limits.
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Ask questions and get help from the Work Incentive Planner (WIP) at your local Department Of Rehabilitation office or a benefits counselor at your local Employment Network (EN) or at your local Work Incentive Planning and Assistance (WIPA) Project.
You don’t have to choose between working and keeping your health coverage. With the right tools and support, you can do both.
Want to learn more and stay inspired? The Department Of Rehabilitation website offers many valuable resources. One of the most powerful tools is our Spotlight on Social Security YouTube channel. There you’ll find webinars and workshops on topics like SSI and Work, Social Security Disability Insurance (SSDI) and Work, Students with Disabilities, and Work Incentive Planning (WIP) Services. You can also explore inspiring success stories from your peers. Let these resources be your roadmap as you explore new and exciting opportunities.