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Individualized 1619(b) Threshold Amounts

If you are otherwise eligible for 1619(b) but have gross earnings that exceed the threshold amount for your State, SSA determines whether you could be eligible under an individualized threshold calculation.

You can estimate the individualized threshold calculation that SSA will do by starting with the threshold amount for your State. Then:

1.                        If your estimated Medicaid expenditures for the next year are greater than the Per Capita Average Medicaid Expenditures for your State, add the difference between your expected expenditures and the average expenditures.

2.                        If you receive a State supplement amount that is higher than the State Supplement amount for an individual living alone, add twice the difference.

3.                        Add the amount of any approved IRWE, BWE, and/or PASS you may have.

4.                        Add the value of publicly-funded personal/attendant care which you receive if:

·     The assistance is provided by a person who is paid under a publicly-funded program other than Medicaid, and

·     You would no longer qualify for attendant care service due to earnings in an amount that causes ineligibility for SSI.

NOTE: Attendant services paid for under Medicaid are considered under the Medicaid component of the individualized threshold and must not be counted again as non Medicaid attendant/personal care services.

See Also: State 1619(b) Thresholds - Overview

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