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Alert: Spouse Medicaid Lost

You and your spouse have combined income that has causes your combined Supplemental Security Income (SSI) cash benefit to be zero. Because you have earnings, you qualify for Medicaid under the work incentive known as 1619b.

Because your spouse has no earnings, however, your spouse will lose Medicaid eligibility – although your spouse may be eligible under another State program. Some States are implementing a Medicaid Buy-In or have other Medicaid options. Check with the agency in your state that administers Medicaid. (See Medicaid Buy-In for information about State Buy-Ins.)

If your spouse were to earn $1 or more per month, your spouse would qualify for Medicaid under 1619b.

There are, however, a number of complications that you should be aware of:

·   Your spouse must have earnings in the same months that you have earnings, that is:

o    If your spouse's earnings do not start on or before the month that your earnings start, your spouse would lose Medicaid coverage;

o    If your spouse were to stop having earnings for a month while your earnings continue, your spouse would lose Medicaid coverage.

·   If your spouse's earnings were high enough that even without counting your earnings, your combined SSI cash benefits would be zero, then:

o    If your earnings do not start on or before the month that your spouse's earnings start, you would lose your Medicaid coverage;

o    If either you or your spouse were to stop having earnings for a month while the other's earnings continue, the one whose earnings stopped would lose Medicaid coverage.

·   If you and/or your spouse also receive Social Security Disability Insurance (SSDI) benefits, then you should be aware that earnings could eventually increase the amount(s) of your SSDI benefits. If the benefits (plus any other unearned income the two of you might have) were to exceed the SSI Federal Benefit Rate (FBR) for couples by $20 or more, then you would both lose your SSI and Medicaid eligibility.

WorkWORLD™ Help/Information System
Topic Title: Alert: Spouse Medicaid Lost
Topic URL: https://help.workworldapp.com/wwwebhelp/alert_spouse_medicaid_lost.htm
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