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FAQs

What is 1619(b)?

Section 1619(b) of the Social Security Act provides one of the most powerful work incentive currently available for SSI recipients: continued Medicaid eligibility for working individuals whose earned income is too high to qualify for SSI cash payments, but not high enough to offset the loss of Medicaid

Section 1619 was added to the Social Security Act in 1987. Part (a) of this section permits eligible SSI recipients to receive a reduced cash payment when earnings exceed the Substantial Gainful Activity amount (SGA). Prior to the passage of this important provision, SSI operated like the other Social Security disability benefit programs in that earnings over SGA caused termination of benefits.

Part (b) of Section 1619 extended these protections, allowing eligible individuals to continue to be considered receiving SSI for the purposes of Title 19 or Medicaid eligibility, even though cash benefits actually ceased due to earned income. Individuals who are utilizing the Section 1619(b) work incentive provision do not receive SSI payments because their income is over the Break-Even Point (BEP) after all exclusions and deductions have been applied. In order to continue Medicaid eligibility, Section 1619(b) participants are legally considered to be receiving an SSI payment for Medicaid purposes, although no actual payment is received.

Why is it Important?

As a work incentive, Section 1619(b) is best known for it’s ability to preserve Medicaid coverage for SSI recipients whose earnings cause total income go over the break-even point. This is an exceptional benefit, but 1619(b) offers more than this since 1619(b) keeps the individual on the SSA computer rolls as SSI eligible, simply not cash benefits status. In addition 1619(b):

  • Allows eligible 1619 (b) recipients to get a SSI cash payment at any time income falls below the break-even point.
  • Enables people who are ineligible for continued Medicaid coverage because earnings exceed the threshold amount to get SSI cash payments again if earnings fall below the break-even point within 12 months.
  • Allows people who are ineligible for continued Medicaid coverage because earnings exceed the threshold amount to regain Medicaid eligibility if earnings drop below the threshold amount within 12 months.
  • Enables people whose eligibility (including 1619(b) eligibility) is suspended for less than 12 months to be reinstated to cash benefits or 1619(b) status without a new application or new disability determination.

POMS Resources:

FAQ Disclaimer: The VCU-BARC FAQ Pages are general information provided as a public service. The contents do not necessarily represent the policy, interpretations or opinion of the Social Security Administration (SSA). The information contained here is intended to inform readers of issues that may affect Social Security and/or other public assistance benefits. Because individual circumstances differ, the reader should not rely on any information here as being specifically applicable to an individual's situation.