|
Neighborhood
Legal Services, Inc.
|
|
SSI & SECTION 1619(b) MEDICAID
In New York State, SSI Recipients Automatically Qualify for Medicaid:
If a person gets as little as $1 in SSI benefits, Medicaid is automatic
Under Section 1619(b), Former SSI Recipients Can Still Get Automatic Medicaid:
The person must lose SSI due to budgeting of wages
- Person living alone in 2008 will lose SSI if gross monthly wages are $1533 or higher
- Person living with others in 2008 will lose SSI if gross monthly wages are $1405 or higher
The person’s disability must continue
Additional Section 1619(b) Criteria (Non-Financial):
Prior month requirement: must have received an SSI check or been eligible for section 1619(b) during 1 month out of previous 12 months
Medicaid use test:
- used Medicaid within past 12 months
- expects to use Medicaid in next 12 months
- unable to pay unexpected medical bill in next 12 months without Medicaid
Section 1619(b)’s Financial Criteria:
Unearned income must be within SSI’s limits
Resources must be within SSI’s limits
Annual income must be under New York State’s section 1619(b) threshold, or it must be under an "individualized threshold"
Section 1619(b)’s Earned Income Threshold:
For calendar year 2008, New York’s earned income threshold is $43,636 per year
If annual wages are below $43,636 and the other criteria is met, Medicaid will continue
Section 1619(b)’s Individualized Threshold
:
If gross earnings are more than the general threshold, eligibility may be established by adding up the following:
- base amount of $18,396 in 2008
- Medicaid amount from threshold chart ($25,240 in 2008), or actual Medicaid expenses if higher
- impairment related work expenses
- blind work expenses
The total of these items establishes the individualized threshold
If annual gross earnings are below this threshold, and other criteria is met, Medicaid will continue
Prepared by Neighborhood Legal Services, Inc. - Updated
January 2008
(716) 847-0650 • Work Incentives Hotline: 1-888-224-3272 • www.nls.org
