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Recommendation: Spouse Apply for Individualized Threshold

Your spouse's annualized gross earned income is greater than the "Threshold" amount for your State.

See: State 1619(b) Thresholds - Overview for an explanation of the threshold concept.

See: State 1619(b) Threshold Amounts for a list of the threshold amounts.

This would ordinarily cause your spouse's Medicaid coverage to stop. Your spouse has, however, sufficient work expenses and/or employability investments included in one or more of the following:

· Blind Work Expenses (BWE)

· A Plan to Achieve Self-Support (PASS)

Your spouse should, therefore, be able to establish an "Individualized Threshold" high enough so that with your spouse's current income, Medicaid coverage should continue.

Action Steps:

1. Determine the amount of your spouse's Individualized Threshold. Since doing so is somewhat complicated, you may want to contact your SSA Claims Representative or an experienced Benefits Specialist. Or, you can follow the instructions in Individualized 1619(b) Threshold Amounts.

2. Create a New Situation based on the situation in which the Recommendation appears.

3. Type a name for the new situation such as "Spouse Individualized Threshold" (optional) and press <Enter>.

4. Scroll down to the question in the Earned Income section and select the answer box for the question on Individualized Threshold. Change the answer from NO to YES and press <Enter>.

5. Enter the amount of your spouse's individualized threshold and press <Enter>.

6. Check your Text Results. If the Individualized Threshold is greater than the Gross Earned Income, then no Alert should appear warning of a loss of Medicaid coverage (and/or no Recommendation to establish an individualized threshold).

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