Health Care Work Incentives

If you get health care benefits like Medicare or Medical Assistance (MA), there are also incentives that make sure you continue to have good health coverage after you get a job.

Medicare

Many people with disabilities get Medicare health coverage, usually because they also get Social Security Disability Insurance (SSDI). If your income goes up while you’re on SSDI, your benefit can go down, though the work incentives described earlier in this article help make it so that you can gradually try out working without fear of suddenly losing your cash benefit. Likewise, you can gradually try out working without fear of suddenly losing your Medicare coverage, thanks to the incentives described here.

Continuation of Medicare Coverage

Once you become eligible for Medicare, you can continue to get Medicare coverage for at least 93 months after your SSDI Trial Work Period (TWP) ends, provided you are still disabled under Social Security’s guidelines. The 93-month period starts the month after the last month of your TWP.

To learn more, read DB101's article on Medicare or Chat with a Hub expert.

Medicare for Persons with Disabilities Who Work

If you are still working after your Continuation of Medicare Coverage period ends, you may be able to buy continued Medicare coverage.

You are eligible to buy Medicare coverage if:

• You are under age 65
• You continue to be disabled
• Your Medicare stopped because of work

For more information about buying Medicare continuation coverage, visit their website or call 1-800-MEDICARE (ph: 1-800-633-4227; TTY: 877-486-2048). The line is open 24 hours a day, 7 days a week. You can also Chat with a Hub expert.

Medical Assistance (MA)

Many people with low income get Medical Assistance (MA) health coverage. Some worry that if they make too much money or save up too much money, they'll lose their health coverage. However, there are work incentives that mean that if you are getting MA now and get a job, you’ll still be able to get good health coverage.

Medical Assistance for Employed Persons with Disabilities (MA-EPD)

Medical Assistance for Employed Persons with Disabilities (MA-EPD) allows you to earn any level of income, build more assets, and get or keep your health care coverage through MA.

To qualify for MA-EPD you must be:

• A Minnesota resident
• At least 16 but less than 65 years old
• Certified disabled by the Social Security Administration or the State Medical Review Team (SMRT)
• Working
• Earning more than $65 per month
• Paying Medicare and Social Security taxes

You must pay a monthly premium for MA-EPD coverage. The premium is based on your income and household size.

MA-EPD pays for things like visits to the doctor, hospital stays, medical equipment, home care services, and mental health services.

To learn more, read DB101's article on MA-EPD or Chat with a Hub expert.

1619(b)

If you’re on Supplemental Security Income (SSI), 1619(b) lets you keep your health care coverage through Medical Assistance (MA), even when your earnings are too high for an SSI cash payment. You can earn up to $74,611 a year and keep your MA coverage.

To qualify, you must:

• Have been eligible for an SSI cash payment for at least 1 month
• Would be eligible for cash payment if it weren’t for your earnings
• Still have a disability
• Still meet all other SSI eligibility rules, including the resources limit
• Need MA in order to work
• Have gross annual earned income that is below $74,611

If your gross earnings are higher than $74,611 you may still be eligible if you have:

• Impairment-Related Work Expenses (IRWEs)
• Blind Work Expenses (BWEs)
• A Plan to Achieve Self-Support (PASS)
• Publicly funded attendant or personal care
• Medical expenses above Minnesota’s per capita amount

To learn more, Chat with a Hub expert.

MinnesotaCare

If you earn too much to keep MA coverage, you may be able to get very similar coverage through MinnesotaCare. You'll pay a small premium (up to $28/month).

To qualify, you must:

• Not be able to get Medicare, MA, or affordable employer-sponsored coverage
• Be a U.S. citizen or have a legal immigration status
• Have income at or below 200% of the Federal Poverty Guidelines (FPG). That's $29,160 or less for an individual, $60,000 or less for a family of four.

To learn more, read DB101's article on MinnesotaCare.

Subsidized Individual Coverage Through MNsure

If your income is too high to qualify for MA, you should be able to buy individual health coverage through MNsure. The government may help you pay for your monthly premium through tax credits. If your family's income is at or below 250% of the Federal Poverty Guidelines (FPG), the government may also help you get a plan that has lower copayments and other expenses.

Note: There is no income limit for getting subsidies that help pay individual coverage premiums. (Before 2021, the limit was 400% of FPG.) To get subsidies, you still must meet other eligibility rules and the premium amount you pay depends on your income and your plan.

To learn more, read DB101's article on Buying Health Coverage on MNsure.