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Work Incentives

  • The Basics
  • SSDI Work Incentives
  • SSI Work Incentives
  • Health Care Work Incentives
  • Affordable Housing Work Incentives
  • Next Steps

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    updated January 17, 2023
    Work Incentives

    The Basics

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    Work incentives are rules that make it easier for people with disabilities who get public benefits to become self-sufficient by helping them when they want to work. Work incentives can allow you to keep your benefits and save for your future while you work. They can help you start a business or save money to go to school. Work incentives also make it easier to start benefits again if you need them.

    The first two pages of this article discuss how incentives can help you if you get Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). The article then looks at incentives that help you if you get Medicare or MO HealthNet coverage. Finally, this article explains what happens if you are currently participating in a housing program. Each page explains how these incentives function and how they help you if you get a job.

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    Learn more

    Supplemental Security Income (SSI)

    SSI helps people with disabilities and seniors who have low income and low resources.

    Social Security Disability Insurance (SSDI)

    SSDI helps people with disabilities who worked and paid Social Security taxes.

    How Health Benefits Work

    Learn about the different ways you may be able to get health coverage.

    Work IncentivesSSDI Work Incentives
    OpenClose
    The BasicsSSDI Work IncentivesSSI Work IncentivesHealth Care Work IncentivesAffordable Housing Work IncentivesNext Steps

    Work Incentives

    • The Basics
    • SSDI Work Incentives
    • SSI Work Incentives
    • Health Care Work Incentives
    • Affordable Housing Work Incentives
    • Next Steps

    Try It

      Work Incentives

      SSDI Work Incentives

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      If you’re getting Social Security Disability Insurance (SSDI), it’s because your disability prevents you from going to work and earning enough to cover your expenses. However, you may want to give work a chance. It is possible that maybe if you just had a bit of time and knew that you wouldn’t lose your benefits, you could succeed at a job.

      That’s why Social Security has made program rules and incentives that can help you get a job without having to worry that you’ll lose the benefits you need. For most people who get SSDI benefits, these work incentives function as a 3-stage process that begins when you get a job that pays more than the Substantial Gainful Activity (SGA) limit:

      1. The Trial Work Period (TWP) lets you work and get benefits at the same time, no matter how much you make.
      2. When the TWP ends, the 3-year Extended Period of Eligibility (EPE) starts and lets you work and get benefits for every month that you do not earn more than the SGA limit ($1,470 in 2023, $2,460 if you’re blind).
      3. For 5 years after you get your last SSDI cash benefits, Expedited Reinstatement (EXR) will let you quickly get back on SSDI if your income drops below the SGA limit and you’re still medically disabled. You won’t have to completely reapply.

      These 3 incentives mean that you can get a job and see how it goes. If it goes well, you’ll be in a better financial situation than before. If it doesn’t go well, you will be able to get SSDI benefits and be in the same situation you were in before you tried working.

      More about SSDI and work on DB101
      • DB101’s SSDI Work Rules Focus is a detailed example story showing SSDI’s work incentives.
      • DB101's SSDI and Work videos can also help you understand what you should know about working while you get benefits.
      • Learn more about SSDI program rules in DB101's SSDI article.

      Trial Work Period (TWP)

      Social Security allows every person on SSDI a 9-month Trial Work Period (TWP) to try working. During your TWP, you can work and earn any level of income (even if it is more than the Substantial Gainful Activity (SGA) limit — $1,470 in 2023, $2,460 if you’re blind) and keep your full SSDI benefits.

      Your TWP is 9 Trial Work months occurring within a 5-year window. Your 9 Trial Work months may occur consecutively (one right after another) or sporadically (not one right after another) within the 5-year window. The window stays open until you have used up all 9 Trial Work months. During your TWP, you will continue to get your full SSDI benefits, no matter how much you earn.

      Trial Work Month

      A Trial Work Month is any month that your gross earnings are more than $1,050 (in 2023).

      If you earn more than $1,050 in a month, you use up 1 Trial Work month. If you earn $1,050 or less, you don’t.

      Note: Before you start working, you should check with Social Security or a Benefits Specialist to see if you've used up any Trial Work months. You may have used up some or all of your Trial Work months in the past and not realized it.

      Extended Period of Eligibility (EPE)

      Once you’ve used up all 9 Trial Work months, your Trial Work Period is over and your 3-year Extended Period of Eligibility (EPE) begins.

      When your gross monthly earnings are less than or equal to the Substantial Gainful Activity (SGA) limit ($1,470 per month in 2023, $2,460 if you’re blind), you will keep getting SSDI benefits.

      Deductions

      During your Extended Period of Eligibility (EPE) and period of Expedited Reinstatement (EXR), Social Security allows for certain deductions when they calculate your earnings. These deductions are things that can help keep your countable earnings below the SGA level and let you keep getting SSDI benefits, even though you have a job. The most common deductions are called Impairment Related Work Expenses (IRWEs) and subsidies. For a more detailed description of deductions, click here.

      During your EPE, the first time you earn over the SGA limit in a month, your 3-month Grace Period begins. During the Grace Period, you will keep getting SSDI cash benefits no matter how much you earn. After your Grace Period ends, your SSDI benefits will be $0 in any month that you earn above the SGA limit.

      If you are not earning above the SGA limit when your 3-year Extended Period of Eligibility (EPE) ends, you will continue to get SSDI benefits. If you are earning more than the SGA limit, you will no longer get SSDI benefits, but you will be able to get back on SSDI if your income drops below the SGA limit and you are still disabled. More about what happens after the EPE ends is discussed later in this article under Expedited Reinstatement.

      Example

      Tony’s EPE begins in March. He earns $600 per month in March, April, and May. Because $600 is less than the SGA level, Tony gets SSDI benefits during these months.

      In June, Tony earns $1,600. He doesn't have any deductions and $1,600 is more than the SGA level ($1,470), so his three-month Grace Period begins. Tony still gets SSDI benefits in June, July, and August, because it's his Grace Period.

      In September, Tony earns $1,550. He’s used up his Grace Period and his earnings are above the SGA level, so Tony isn't due any SSDI benefits for September. In October, his earnings dip below the SGA level again, so he is due his SSDI benefits for that month. In November, he earns more than the SGA level, so he isn't due SSDI benefits for the month.

      During Tony’s three-year EPE, every month he earns less than the SGA level, he is due to get SSDI benefits. Every month he earns more than the SGA level, he isn’t due SSDI benefits.

      Notes:

      • It is always important to report any changes in work and income to Social Security right away to avoid overpayments.
      • It is also important to report when your earnings are below the SGA level. Contact Social Security and ask that your benefits be "reinstated." If you don’t, you won't get SSDI benefits, even if your earnings are less than the SGA limit.

      Expedited Reinstatement (EXR)

      After you use up your Trial Work Period and Extended Period of Eligibility (EPE), your SSDI benefits stop if you are earning above the Substantial Gainful Activity (SGA) limit. Expedited Reinstatement (EXR) allows you to get up to 6 months of temporary SSDI cash benefits if your income drops back below the SGA limit.

      During those 6 months, Social Security will conduct a medical review to see if you still meet their definition of disability. If you do, your benefits can start again without you having to reapply. If you are not considered to be disabled, your temporary SSDI cash benefits will stop. If you have questions about Expedited Reinstatement, talk to a Benefits Specialist.

      Deductions

      During your Extended Period of Eligibility (EPE) and the period of Expedited Reinstatement (EXR), there are some ways to lower the amount of earnings Social Security counts to figure out if you’re over the Substantial Gainful Activity (SGA) limit. These are called “deductions.” Here we’ll talk about the most common deductions that can help you lower your gross monthly earnings below the SGA limit, so that you can work and keep getting your SSDI benefits check.

      Note: These deductions cannot be used during the Trial Work Period (TWP).

      Impairment Related Work Expenses (IRWEs)

      Impairment Related Work Expenses (IRWEs) are things you pay for yourself that are related to your disability and that you need to work. Social Security doesn’t count earned income that you use to pay for these expenses when they calculate your income. IRWEs include things like:

      • Medication
      • Adaptive equipment
      • Vehicle modifications
      • Personal care attendant costs
      • Special transportation costs

      Social Security must approve the items that you want counted as IRWEs. You can use this form to request that Social Security approve your IRWEs. If the IRWEs are approved, Social Security will deduct these expenses from your income when they are calculating your SSI benefits amount or figuring out Substantial Gainful Activity. That makes it more likely that you will continue to get SSDI benefits.

      Subsidies and Special Conditions

      Subsidies and special conditions are supports you get on the job that result in you getting more pay than the actual value of the services you perform. A subsidy is support that you get from your employer; special conditions are generally supplied by someone other than your employer, for example, a Vocational Rehabilitation agency.

      Social Security considers subsidies and special conditions when they make an SGA decision. They only use earnings that represent the real value of the work you do to decide if your work is at the SGA limit. This is good for you because if Social Security decides that you have a subsidy or special conditions, you can earn more while still getting benefits.

      Subsidies or special conditions may exist if:

      • You get more supervision than other workers doing the same or a similar job for the same pay
      • You have fewer or simpler tasks to complete than other workers doing the same job for the same pay, or
      • You have a job coach or mentor who helps you perform some of your work.

      If you think you get a subsidy, talk to Social Security about it. They may ask you to get a letter from your employer, so they can document that you get a subsidy. If you think special conditions may apply to you, talk about it with Social Security. Also talk to your mentor or job coach — they may need to supply documentation so that you can be recognized as having a special condition.

      Unincurred Business Expenses (Self-Employment)

      Unincurred Business Expenses are contributions made by others to your self-employment business effort. Examples include things like:

      • A friend working for free
      • A government agency paying for some of your business expenses
      • Someone giving you things of value — such as office space free of charge

      Social Security deducts the value of any unincurred business expenses from your net income when deciding if you have reached the SGA limit for any given month. Social Security uses fair market value to assess the value of any unincurred business expenses.

      Example

      Joe gets office space from his Vocational Rehabilitation agency at no charge. The value of the office space is $300 per month.

      Joe’s net income is $1,670 per month (higher than the $1,470 SGA limit). Social Security deducts the $300 for the office space from Joe’s $1,670, so Joe’s countable income is only $1,370. He is not over the SGA limit and will keep getting SSDI benefits.

      Plan to Achieve Self-Support (PASS)

      A Plan to Achieve Self-Support (PASS) lets people who get Supplemental Security Income (SSI) save money for a work-related goal. Income that is put into a PASS does not count as earnings by SSI and the money you save is not counted as resources.

      If you get SSDI benefits, it only helps you if you also get SSI benefits or if you would qualify for SSI benefits if you put some of your earnings into a PASS. For more information on Plans to Achieve Self-Support, click here.

      Example

      Juan has a disability and gets a $600 SSDI check each month. He also gets a $334 SSI check each month. Between the 2 benefits, he’s just able to cover his expenses.

      He talks to a Benefits Specialist and learns that if he puts $580 of his SSDI benefits into a PASS, then SSI wouldn’t count that money when they calculate his benefits. That means that when Juan puts his SSDI money into the PASS, Social Security will give him more SSI benefits!

      He decides to put the SSDI money each month into a PASS that will let him save up money to go to a community college. Now, he still gets his $600 SSDI check, but saves almost all of it in his PASS. His SSI check went up to $914, because SSI isn’t counting the money he saves in the PASS.

      He still has the same amount of money to cover his expenses, but now he’s also saving up money and will be able to get the training he needs to get a job in the future.

      Continued Payment - Section 301

      Section 301 lets you continue to get SSDI benefits, even if you no longer meet Social Security’s criteria for being disabled, as long as you are participating in an approved Vocational Rehabilitation (VR) program that is expected to help you become self-supporting.

      Programs and providers that are usually approved for Section 301 include:

      • Ticket to Work providers
      • The Missouri Division of Vocational Rehabilitation
      • Support services that use individualized written employment plans
      • A Plan to Achieve Self-Support (PASS)
      • An Individualized Education Program (IEP) (persons ages 18 – 21)

      To find out if a specific provider or program is approved under Section 301, talk to a Benefits Specialist or visit your local Social Security office. You can also call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY).

      SSDI and Work Videos

      Watch this video to see how planning helps you know what to expect with your SSDI when you go to work:

      PLaCwYJd0N4tEyL4QrPDGXYGaNzOMwM53H

      Watch this video to understand how SSDI's rules can help you when you go back to work:

      PLaCwYJd0N4tFnKIcId8dKJ9JxtYBK_ziF

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      • Previous
      • Next

      Learn more

      Supplemental Security Income (SSI)

      SSI helps people with disabilities and seniors who have low income and low resources.

      Social Security Disability Insurance (SSDI)

      SSDI helps people with disabilities who worked and paid Social Security taxes.

      How Health Benefits Work

      Learn about the different ways you may be able to get health coverage.

      Work IncentivesSSI Work Incentives
      OpenClose
      The BasicsSSDI Work IncentivesSSI Work IncentivesHealth Care Work IncentivesAffordable Housing Work IncentivesNext Steps

      Work Incentives

      • The Basics
      • SSDI Work Incentives
      • SSI Work Incentives
      • Health Care Work Incentives
      • Affordable Housing Work Incentives
      • Next Steps

      Try It

        Work Incentives

        SSI Work Incentives

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        If you’re getting Supplemental Security Income (SSI), it’s because your disability prevents you from going to work and earning enough to cover your expenses. However, you may want to give work a chance. It is possible that maybe if you just had a bit of time and knew that you wouldn’t lose your benefits, you could succeed at a job.

        That’s why Social Security has made program rules and incentives that can help you do so without having to worry that you’ll lose the benefits you need. You can try out getting a job, earn some money, and even save up some money in the bank without losing your SSI benefits. Here we’ll explain how.

        When SSI figures out how large a benefit to give you, they look at how much money you make. The Earned Income Exclusion means that SSI doesn’t count the first $65 of your earnings in a month. After that, SSI only counts half of the rest of your earnings. So, if you get a job, SSI counts less than half of your earnings when determining your SSI payment amount.

        DB101's SSI and Work videos can also help you understand what you should know about working while you get benefits.

        Learn more about SSI program rules in DB101's SSI article.

        On SSI? Get a quick estimate of how working may affect your income
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        Earned Income Incentives

        When SSI figures out how large a benefit to give you, they look at how much money you make. The Earned Income Exclusion means that SSI doesn’t count the first $65 of your earnings in a month. SSI also doesn’t count an additional $20 of general income, which could be earned income or unearned income, including some benefits such as Social Security Disability Insurance (SSDI). After that, SSI only counts half of the rest of your earnings.

        The bottom line: If you get a job, SSI counts less than half of your earnings when determining your SSI payment amount.

        1619(a)

        Generally, to qualify for SSI, you must have a disability that prevents you from working. However, after you have been on SSI for a while, you may find that you are able to do some work. If that happens, 1619(a) allows you to keep getting SSI benefits, even when you have earned income above the Substantial Gainful Activity (SGA) limit.

        To qualify, you must:

        • Have been eligible for SSI benefits for at least one month before you began working above the SGA level ($1,470 in 2023, $2,460 if you’re blind)
        • Still be disabled
        • Meet all other eligibility rules, including SSI’s resource limits ($2,000 if you’re single, $3,000 for couples)
        Example

        You are single. You have been getting SSI benefits for 6 months and you just got a new part-time job. Even though you are now working and earning more than the SGA limit, 1619(a) means that you may continue to qualify to get SSI benefits. Social Security applies the SSI formula to figure out your countable income:

        Countable Earned Income Example:
        Your Earned Income$1,300
        Minus the $20 General Exclusion- $20
        Minus the $65 Earned Income Exclusion- $65
        Subtotal
        Divide by two÷ 2
        Your Countable Income
        SSI Benefit Calculation
        SSI Maximum Benefit$914.00
        Minus Total Countable Income- 
        Your SSI Benefit

        Even with 1619(a), when your countable income goes above the maximum SSI payment amount (also called the Federal Benefit Rate; $914 in 2023), your SSI benefits will go down to $0. However, you may still qualify for 1619(b), which is an incentive that lets you keep your MO HealthNet coverage, even though you no longer get SSI benefits. 1619(b) is discussed in more detail here.

        Student Earned Income Exclusion (SEIE)

        The Student Earned Income Exclusion (SEIE) helps students keep more of their SSI checks while they work and are in school. If you are a student under the age of 22, SSI won’t count any of your earnings when figuring out your SSI benefits amount, unless you make more than $2,220 per month.

        There is a maximum exclusion of $8,950 per year in 2023. To read more about the Student Earned Income Exclusion, click here.

        Impairment Related Work Expenses (IRWE)

        Impairment Related Work Expenses (IRWEs) are things you pay for yourself that are related to your disability and that you need to work. Social Security doesn’t count earned income that you use to pay for these expenses when they are calculating your income. IRWEs include things like:

        • Medication copays
        • Adaptive equipment
        • Vehicle modifications
        • Personal care attendant costs
        • Special transportation costs

        To see a list of deductible and nondeductible IRWEs from Social Security’s Red Book, click here.

        Social Security must approve the items that you want counted as IRWEs. You can use this form to request that Social Security approve your IRWEs. If the IRWEs are approved, Social Security will deduct these expenses from your income when they are calculating your SSI eligibility or benefits amount.

        Blind Work Expenses (BWEs)

        Blind Work Expenses (BWEs) can only be used by people who get SSI benefits and who are blind. If you are blind, Social Security doesn’t count earned income that you use to pay for expenses when you work. BWEs include things like:

        • Transportation costs to and from work
        • Guide dog expenses
        • Income taxes

        Social Security must approve the items that you want counted as BWEs. You can use this form to request that Social Security approve your BWEs. If the BWEs are approved, Social Security will deduct these expenses from your income when they are figuring out your SSI eligibility or benefits amount.

        Plan to Achieve Self-Support (PASS)

        A Plan to Achieve Self-Support (PASS) lets you save money for a work-related goal that will help you be more self-sufficient. Usually, your SSI benefits go down when you get income from other sources, like a job or Social Security Disability Insurance (SSDI). But with a PASS, Social Security does not count income or resources set aside in the PASS when figuring out your SSI eligibility or benefits amount. That means you can save up money and keep getting your SSI benefits at the same time.

        You can use a PASS to:

        • Help pay for the cost of school or training
        • Start a business
        • Pay for equipment, support services, and other expenses related to your goal

        To set up a PASS, you must do the following:

        • Be on SSI or become eligible for the SSI program as a result of an approved PASS application. (If you are not eligible for SSI benefits because of the limit on resources, you may be able to move those resources into a PASS and become eligible.)
        • Have a source of income other than SSI (for example, Social Security Disability Insurance (SSDI) cash benefits or wages from a job).
        • Have a work goal that eventually will help you earn enough money to lower or get off Social Security disability benefits.
        • Be able to write a plan that shows how saving a certain amount of money will let you reach your work goal. Social Security has staff called PASS Cadre who can help you write your PASS plan.
        • Be under age 65. You may be able to set up a PASS if you are 65 or older, if you were getting SSI cash benefits based on disability or blindness in the month before your 65th birthday.

        The PASS plan is about your work goal, what you want to achieve, and what you need to get there. After you write your PASS, you ask Social Security to approve it. Your plan must have a realistic goal that considers your abilities, experience, and educational background.

        Once you have an approved PASS plan, you will need to open a separate bank account just for your PASS funds. You cannot put any money you get from SSI into your PASS account. Your SSI benefits should be used for basic expenses like food and housing. You must fund your PASS account with money from other sources, such as income from a job or money from a spouse or parent. You will use the money you have put into your PASS account to pay for approved expenses to reach your goal.

        For more information about the PASS program, see the DB101 article on Building Your Assets and Wealth.

        Continued Payment - Section 301

        Section 301 lets you continue to get SSI benefits, even if you no longer meet Social Security’s criteria for a disability, as long as you are participating in an approved Vocational Rehabilitation program that is expected to help you become self-supporting.

        Programs and providers that are usually approved for Section 301 include:

        • Ticket to Work providers
        • The Missouri Division of Vocational Rehabilitation
        • Support services that use individualized written employment plans
        • A Plan to Achieve Self-Support (PASS)
        • An Individualized Education Program (IEP) (persons ages 18 – 21)

        To find out if a specific provider or program is approved under Section 301, talk to a Benefits Specialist or visit your local Social Security office. You can also call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY).

        Expedited Reinstatement (EXR)

        Expedited Reinstatement (EXR) allows your SSI benefits to start again, without a new application, if they stopped because of work. EXR can be used by people who got SSI benefits in the past, but it is not very common because of the 1619(b) rules.

        To be eligible for EXR, you must request it within 5 years of the last month that you were last eligible for 1619(b). If you have questions about Expedited Reinstatement, talk to a Benefits Specialist.

        Property Essential to Self-Support (PESS)

        Property Essential to Self-Support (PESS) is anything that you own and need to support yourself. Social Security does not count these things as resources when figuring out if you are eligible for SSI benefits. Three types of property can be excluded as PESS:

        • Property that you use in a trade or business (for example, your inventory) or personal property you use for work as an employee (for example, tools or equipment)
        • Up to $6,000 of the value of nonbusiness property that you use to produce something that helps with your daily living (for example, land that you use to produce vegetables that you eat)
        • Up to $6,000 of the value of property if the property gives you a return of at least a 6% per year (for example, property you own and rent to someone else)

        You must be using the property to support yourself or expect to start using it again within a reasonable period of time, usually 12 months.

        SSI and Work Videos

        Watch this video to understand what to expect with your SSI when you go to work:

        PLaCwYJd0N4tHAajxuJJTLAKjKfyBSr62t

        Watch this video to learn what happens when a young person who gets SSI benefits starts working:

        PLaCwYJd0N4tF4KhMm9_MGooZaC-Cid3AS

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        • Previous
        • Next

        Learn more

        Supplemental Security Income (SSI)

        SSI helps people with disabilities and seniors who have low income and low resources.

        Social Security Disability Insurance (SSDI)

        SSDI helps people with disabilities who worked and paid Social Security taxes.

        How Health Benefits Work

        Learn about the different ways you may be able to get health coverage.

        Work IncentivesHealth Care Work Incentives
        OpenClose
        The BasicsSSDI Work IncentivesSSI Work IncentivesHealth Care Work IncentivesAffordable Housing Work IncentivesNext Steps

        Work Incentives

        • The Basics
        • SSDI Work Incentives
        • SSI Work Incentives
        • Health Care Work Incentives
        • Affordable Housing Work Incentives
        • Next Steps

        Try It

          Work Incentives

          Health Care Work Incentives

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          If you get health care benefits like Medicare or MO HealthNet, there are also incentives that make sure you continue to have good health coverage after you get a job.

          Note: DB101 keeps track of changes to health coverage and related laws. DB101 articles and tools have recently been updated to include MO HealthNet's expansion of coverage for adults 18-64 years old (Medicaid Expansion). Get more information about applying for this coverage.

          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 benefits can go down, though the work incentives described earlier in this article can help you to gradually try out working without fear of suddenly losing your cash benefits. 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 getting Medicare coverage for at least 93 months (or 7 years and 9 months) after your SSDI Trial Work Period (TWP) ends, if you are still disabled under Social Security’s guidelines. The 93-month period starts the month after the last month of your TWP.

          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 Medicare’s website or call them at 1-800-633-4227 or 1-877-486-2048 (TTY). The line is open 24 hours a day, 7 days a week. You can also talk to a Benefits Specialist.

          Learn more about Medicare in DB101's How Health Benefits Work article.

          MO HealthNet

          Many people with disabilities get MO HealthNet health coverage. Some worry that if they make too much money or save up too much, they'll lose their health coverage. However, if you have a disability, there are a few ways you can keep your MO HealthNet while working and earning more than the usual income limits for income-based MO HealthNet or disability-based MO HealthNet:

          1. You can get MO HealthNet with a spend down
          2. You can get MO HealthNet through the Supplemental Security Income (SSI) 1619(b) rule
          3. You can get MO HealthNet through a program called Ticket to Work Health Assurance (TWHA)

          To qualify through these you must:

          • Have or apply for a Social Security number
          • Live in Missouri and intend to remain in the state
          • Be a United States citizen or an eligible noncitizen
          • Have limited resources
            • For most MO HealthNet programs, including the spend down and TWHA, you must have less than $5,302 in available resources ($10,604 for couples).
            • For people who get MO HealthNet through 1619(b), the resource limit is the same as SSI’s, $2,000 for an individual, $3,000 for a couple.

          The amount of money you can make and whether you have to pay a monthly premium or spend money of your own for care depends on your situation. Here we’ll explain the differences between these three rules.

          Learn more about MO HealthNet in DB101's How Health Benefits Work article.

          MO HealthNet with a Spend down

          If you make more than MO HealthNet’s income limit, you may qualify for MO HealthNet with a spend down. A spend down is like an insurance deductible. With a spend down, you are responsible for part of your medical expenses each month before MO HealthNet will start paying for them.

          Each month you have the option of meeting the spend down by paying for some of your medical expenses directly (like a deductible) or by paying your spend down amount to MO HealthNet (like a premium).

          Whichever of these options you choose, every month when you meet the spend down, you will get MO HealthNet coverage. When you don’t meet the spend down, you won’t get MO HealthNet coverage. You may choose to meet the spend down some months and not in other months, if you do not have health care expenses every month.

          SSI’s 1619(b) Program

          For people on SSI, the 1619(b) program lets you work and keep MO HealthNet, even if you make too much money to get SSI cash benefits. If you are on this program, you will not have to pay a premium or meet a spend down.

          In addition to the eligibility requirements listed earlier for all MO HealthNet programs, to qualify for MO HealthNet based on 1619(b) you must:

          • Be found eligible for 1619(b) status by Social Security
          • Have gotten MO HealthNet in the month prior to becoming eligible for 1619(b) status

          To be eligible for 1619(b) status you must:

          • Have been eligible for SSI cash benefits for at least 1 month
          • Be working and have gross earnings below $49,608 per year
          • Not be getting SSI benefits because you earn too much
          • Still be considered disabled or blind by SSI
          • Need MO HealthNet to be able to work
          • Not make enough money to pay for the services you get with MO HealthNet benefits
          • Respond to all Social Security requests for information

          Note: When your income is counted, Social Security won’t count all of your income, thanks to various SSI work incentives. So you may be making more than $49,608 per year and still qualify for 1619(b).

          MO HealthNet Ticket to Work Health Assurance (TWHA) Program

          When you have a job and your income is more than regular MO HealthNet allows, you may be eligible for the Ticket to Work Health Assurance (TWHA) program. TWHA covers the same services that standard MO HealthNet covers, including visits to the doctor, hospital stays, medical equipment, home care services, and mental health services. The program encourages you to work and enjoy the benefits of working without having to worry that you’ll lose your health benefits.

          In addition to the eligibility requirements listed earlier for all MO HealthNet programs, to qualify for TWHA you must:

          • Be age 16 – 64
          • Be working and paying Social Security and Medicare taxes
          • Get Social Security disability benefits or considered disabled by the Missouri Department of Social Services (DSS) Family Support Division (FSD)
          • Have gross income of $3,398 per month or less for an individual, $4,578 or less for a couple.
          • Also meet countable net income limits. Your countable net income is calculated by the Family Support Division and includes various deductions from your gross income.

          Depending on your gross income, you may have to pay a monthly premium for this type of MO HealthNet coverage. Premiums range from a minimum of $45 per month to a maximum of $229 per month, depending on your situation.

          Learn more about Ticket to Work Health Assurance in DB101's How Health Benefits Work article.

          Subsidized Individual Coverage Through Healthcare.gov

          If your income is too high to qualify for MO HealthNet, you should be able to buy individual health coverage through Healthcare.gov. 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.

          Learn more about individual coverage in DB101's How Health Benefits Work article.

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          Supplemental Security Income (SSI)

          SSI helps people with disabilities and seniors who have low income and low resources.

          Social Security Disability Insurance (SSDI)

          SSDI helps people with disabilities who worked and paid Social Security taxes.

          How Health Benefits Work

          Learn about the different ways you may be able to get health coverage.

          Work IncentivesAffordable Housing Work Incentives
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          Work Incentives

          • The Basics
          • SSDI Work Incentives
          • SSI Work Incentives
          • Health Care Work Incentives
          • Affordable Housing Work Incentives
          • Next Steps

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            Work Incentives

            Affordable Housing Work Incentives

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            Earned Income Disregard (EID)

            Many people with disabilities participate in housing programs that can make renting an apartment or purchasing a home more affordable. These programs include:

            • Section 8 Housing Choice Voucher (HCV) Program
            • Public Housing
            • HOME Investment Partnerships Program
            • Housing Opportunities for Persons with AIDS (HOPWA)

            If you have a disability and participate in one of these affordable housing programs and get a job, you may qualify for the Earned Income Disregard (EID).

            The Earned Income Disregard (EID) is earned income that is excluded (not counted) as part of your annual income for rent calculation when you begin earning income or earn additional income. The EID allows your rent to stay the same when you start working. Here’s how it works:

            • For the first 12 months after you start working, income from your job is not counted towards your rent, so the amount you pay in rent stays the same.
            • In the second 12 months, your housing authority will only count half of your total work earnings towards rent.
            • The exclusion period is 24 months in a row. If you don’t work in some of those months and can’t use the exclusion in those months, the months still count as part of the 24 month total. Once the 24 months have passed, applicants cannot get the EID for rent.

            Many, but not all, public and subsidized housing programs offer an EID. If you are thinking about getting a job, talk to your housing provider to see if this work incentive is available.

            Family Self-Sufficiency (FSS) Program

            The Section 8 Housing Choice Voucher Program helps people with low income have affordable housing. It is funded by the federal government and run by local public housing authorities (PHAs).

            A family that gets Section 8 benefits pays 30% of the family income for rent. The Section 8 program pays for the rest of the rent. After a family's income goes up, the amount the family has to contribute to rent also goes up, because 30% of their income is more than it used to be. When the family contributes more for rent, the Section 8 program contributes less. Note: Families that include a person with a disability who works may qualify for the Earned Income Disregard and not have to pay more rent (see below).

            Section 8's Family Self-Sufficiency (FSS) program helps families whose income goes up. When the family income goes up and the Section 8 program starts paying less for rent, the Section 8 program takes the money that it saves on rent and sets it aside for the family. The family can use these savings for purchases, such as the down payment on a home or a car.

            Learn more about the FSS. Find public housing authorities near you.

            Example

            Clyde and Bertha live with their two children and have $500 in monthly income. Due to their low income, they qualify for the Section 8 program. With Section 8, they pay just $150/month in rent (30% of $500), even though their apartment costs $1,000/month. Section 8 pays the remaining $850/month.

            Bertha starts doing some childcare work and the family income goes up to $1,000 each month. Now, they have to pay $300/month as rent (30% of $1,000), while Section 8 pays the remaining $700/month for the family's apartment, $150 less per month than the program used to pay.

            Because the family is part of the FSS program, the PHA that administers Clyde and Bertha's Section 8 benefits takes that $150 each month and sets it aside for the family. A year later, there is $1,800, which Bertha can use to make the down payment on a car.

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            • Previous
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            Learn more

            Supplemental Security Income (SSI)

            SSI helps people with disabilities and seniors who have low income and low resources.

            Social Security Disability Insurance (SSDI)

            SSDI helps people with disabilities who worked and paid Social Security taxes.

            How Health Benefits Work

            Learn about the different ways you may be able to get health coverage.

            Work IncentivesNext Steps
            OpenClose
            The BasicsSSDI Work IncentivesSSI Work IncentivesHealth Care Work IncentivesAffordable Housing Work IncentivesNext Steps

            Work Incentives

            • The Basics
            • SSDI Work Incentives
            • SSI Work Incentives
            • Health Care Work Incentives
            • Affordable Housing Work Incentives
            • Next Steps

            Try It

              Work Incentives

              Next Steps

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              Find a Job

              Contact a Vocational Rehabilitation (VR) office in your area to sign up for an orientation to learn about the eligibility requirements and services VR offers. The program offers a variety of services to people with disabilities to prepare for, get, and keep employment.

              Missouri Job Centers can help you find a job and plan for your career. To find a Missouri Job Center near you, call 1-888-728-5627 (1-888-728-JOBS) or click here for a list of all Job Centers in Missouri.

              Jobs.mo.gov is an online service where you can look for jobs.

              The U.S. Department of Labor's My Skills, My Future website helps job seekers match their skills with new careers and find out what training is needed to move from one job to another.

              Apply for Benefits

              You can apply for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI):

              • By calling Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY)
              • At your local Social Security Office

              You can also apply for SSDI online. If you have an appointment with Social Security, it's a good idea to review the Disability Starter Kit to prepare.

              The MO HealthNet website has instructions on how to apply for health coverage online, by phone, or by mail.

              Ticket to Work

              Social Security’s Ticket to Work Program helps people with disabilities who get Social Security benefits re-enter the workforce and become more independent. The Ticket to Work Program offers free access to employment-related services, such as training, transportation, and vocational rehabilitation.

              Benefits Planning Services

              If you're currently on SSI, SSDI, or CDB benefits, and you're looking for a job, a trained Benefits Specialist can help you avoid complications when you are working on a job plan for your future. For questions or guidance specific to your situation, you can speak to someone at the Ticket to Work Help Line at 1-866-968-7842 (1-866-833-2967 TTY/TDD) Monday through Friday from 8:00AM - 8:00PM EST.

              LikeTweetPrintEmailGive feedback
              Add to favoritesAdd to favorites
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              • Previous

              Learn more

              Supplemental Security Income (SSI)

              SSI helps people with disabilities and seniors who have low income and low resources.

              Social Security Disability Insurance (SSDI)

              SSDI helps people with disabilities who worked and paid Social Security taxes.

              How Health Benefits Work

              Learn about the different ways you may be able to get health coverage.