Section 1619b of the Social Security Act allows individuals who are eligible for Supplemental Security Income (SSI) to continue to be eligible for Medicaid coverage when their earnings are too high to continue to receive SSI. This work incentive applies to individuals whose earnings are below Indiana’s threshold (currently $32,615 in 2009).

How it Helps You:

If you are eligible for SSI and are employed, 1619b allows you to work and to keep Medicaid coverage without a Medicaid spend-down. You can continue to be eligible for Medicaid coverage until your gross annual income reaches a certain amount (this amount is $32,615 in 2009 if you are living in Indiana).

Exceptions to this work incentive are if you no longer need Medicaid, or if you accumulate more than $1,500 in resources (this is Indiana’s Medicaid resource limit).

How it Works:

While you are earning income from work, if you have a disability or are blind, if you need Medicaid in order to work, if you are unable to afford benefits, and you meet all other requirements (such as less than $1,500 in resources, which is Indiana’s resource limit), you are eligible for 1619b Medicaid protection.

You should report your earnings to the Social Security Administration (SSA) monthly. At the time that SSI cash payments stop due to reaching the Break Even Point, the SSA computer will automatically determine eligibility for 1619b, and inform you of your eligibility for this Medicaid protection.

This information will be sent electronically to the local office of the Division of Family Resources (DFR). However, you should also report your earnings to the caseworker at the DFR, and inform them that you are eligible for Section 1619b Medicaid protection.

An Indiana Works Community Work Incentives Coordinator  and the Social Security Administration can help you in understanding the conditions to continue with Medicaid coverage under Section 1619b.

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