Myth 3: If I Work, I'll Lose Health Benefits

Losing your health care benefits can be a huge concern if you are thinking about work. However, there are several programs that can help you keep your health care benefits when you go to work. Some jobs will offer employer-sponsored health care benefits. But for some people that will not be enough. Some people may also want to keep their Medicare or Medical Assistance (MA) benefits. The information below will explain several different options for health care benefits.

Medical Assistance (MA)

Keeping MA is a big concern for people with disabilities who want to work.

Eligibility for MA is based on your income and, depending on your situation, on your assets. There are a couple of common ways you may qualify:

• If you are under 65 years old, don't get Medicare, and your family's income is at or below 138% of the Federal Poverty Guidelines (FPG) ($20,783 per year if you are single; $43,056 for a family of four). There's no asset limit if you meet these rules. This way to qualify for Medical Assistance (MA) is explained in DB101's MA article.
• If you have a disability or are 65 or older and your countable income is at or below 100% of FPG, which is $15,060 for a single person. Your assets must also be less than $3,000 if you're single ($6,000 for a family of two), and you must approve the use of the Account Validation Service (AVS) so that MA can make sure your assets are below the limit. Money in an ABLE account does not count against these limits. Note: Countable income is not the same as total income. See DB101's MA for People with Disabilities article to learn more about how MA counts your income.

If you work and your income is low enough, you should be able to qualify in these ways for Medical Assistance (MA). But $20,783 per year or less is not a lot of money to live on and $3,000 is probably not enough money in the bank to meet your needs. And what if you want to save money to buy a car or a house or go on vacation? There are several other ways you can keep your Medical Assistance (MA) while working and earning and saving more.

If you have a disability, you may have to pay a spenddown to keep your MA coverage. However, that can be very expensive. SSI's 1619(b) rule and Medical Assistance for Employed Persons with Disabilities (MA-EPD) are both better options than paying a spenddown for MA coverage. To learn more, read below or Chat with a Hub expert.

SSI’s 1619(b) Program

If you are working, you can continue to get Medical Assistance (MA) coverage even if your earnings are too high to get an SSI cash payment. If you are on 1619(b), you can earn up to $74,611 annually and keep your MA coverage without having to pay a spenddown.

For 1619(b), your assets need to stay under SSI's asset limit as well: $2,000 for an individual, $3,000 for a couple. One way to keep your assets below the asset limit is to put your money in an ABLE account. The first $100,000 you have in your ABLE account won’t affect your SSI eligibility, which means it won't affect 1619(b). Learn more in DB101's ABLE accounts article.

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

MA-EPD is another great program for Minnesotans with disabilities. The MA-EPD program lets working people with disabilities qualify for MA coverage no matter what their income is or how much they have in assets. To be on MA-EPD, you have to pay a premium. The premium is based on your income and the size of your household.

For more information, read DB101's MA-EPD section. To see if you might qualify for the program and what your premium would be, use DB101's MA-EPD Estimator.

Employer-Sponsored Health Care Benefits

If you’re working, you can enroll in your company’s employer-sponsored health care plan and still keep your 1619(b) coverage, Medicare, or MA-EPD. In fact, if the employer-sponsored plan requires you to pay for a share of the cost, the state may pay for some or all of that for you (if they figure out that it is cost effective for them to have you covered under both health care plans).

You can read more about employer-sponsored health coverage and other types of private coverage in DB101's section on Private Health Coverage.

Medicare

If you continue to receive your SSDI when you work, your eligibility for Medicare simply continues. You can also keep your Medicare even if earnings cause your SSDI check to stop, as long as Social Security still considers you disabled. If your SSDI stops due to work, you can keep your Medicare coverage for at least 7 years and 9 months from the end of your Trial Work Period. After that, if you still have a disability and would like to keep Medicare, you can maintain it by paying a monthly Part A premium.

If you have any questions about this, Chat with a Hub expert or read Social Security's FAQ for more details.