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Alert: Keeping Medicaid

Your Supplemental Security Income (SSI) cash benefit is zero because of earnings. As a work incentive, the Social Security Administration (SSA) allows you to keep Medicaid coverage in order to continue working. This work incentive is called "1619(b)".

In order to keep Medicaid coverage you must inform your SSA Claims Representative that you need Medicaid to work. See the SSA Sample 1619(b) Referral Letter for additional information and a sample letter you can use for the notification.

When your earnings are high enough that your SSI cash benefit goes to zero, your Claims Representative is supposed to ask you three questions:

·   "Have you used any medical care or services in the past 12 months that was paid for by Medicaid (or Medi-Cal, etc.)?"

·   "Do you expect to receive any medical care or services in the next 12 months that will be paid for by Medicaid (or Medi-Cal, etc.)?"

·   "Without Medicaid (Medi-Cal, etc.), would you be unable to pay your medical bills if you become ill or injured in the next 12 months?"

If you answer "Yes" to any one of those questions, then your SSA Claims Representative is supposed to presume that you need Medicaid in order to work and place you in 1619(b) status. (The POMS reference is: SI 02302.040.)

NOTE: In States with more restrictive criteria, you should make sure that your State agency administering Medicaid is informed of your 1619b status.

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