Shown below is a sample letter you can send to your Claims Representative at the Social Security Administration (SSA). You can use this letter to inform SSA of your need for continued Medicaid coverage under section 1619(b) when your earnings become high enough to cause your Supplemental Security Income (SSI) benefits to stop.
To continue your Medicaid coverage, you must:
· Have been eligible for an SSI cash payment for at least one month;
· Still meet the disability and non-disability requirements;
· Need Medicaid in order to work (see Medicaid Need Test); and
· Have earnings below a specified threshold level. Usually, SSA uses your State's 1619(b) Threshold Amount when deciding 1619(b) eligibility. Alternatively, you may be able to establish a higher Individualized 1619(b) Threshold Amount if any of the following are true:
o your personal medical expenses are high,
o you receive certain types of State SSI Supplements,
o you use publicly-funded personal/attendant care, or
o you have an IRWE, BWE, or PASS.
See the Contacting the Social Security Administration topic if you don't know who your SSA Claims Representative is, you need to discuss Individualized Thresholds, or you need other contact information for your local SSA Field Office.
Every State has a Protection and Advocacy Agency that operates the Protection & Advocacy for Beneficiaries of Social Security (PABSS) program. This agency can provide you with free information and referral, technical assistance, advocacy and/or legal representation if you are having difficulty accessing or have been inappropriately denied 1619(b) benefits.
Please remember that this letter is intended to increase the likelihood that 1619(b) eligible individuals will continue their Medicaid coverage. Use of the sample letter does not guarantee Medicaid coverage.
This sample letter was adapted for consumer use from an example provided by the Virginia Department of Medical Assistance Services (DMAS). For a similar sample letter worded for use by an advocate or agency on behalf of a consumer, see the DMAS web page at:
Information for this topic was drawn from the DMAS website at:
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