The current threshold amounts for each state are shown in the POMS at: Social Security revises charted threshold amounts on an annual basis. If Social Security determines the individual’s countable earned income for the 12-month period is equal to or less than the threshold amount shown on the chart, he or she meets this threshold requirement. 1619(b) Individualized Threshold Amounts If an individual has gross earnings above the charted threshold amount for the state, Social Security can look to see if the agency should calculate a higher individualized threshold. A person may get a higher individualized threshold amount if he or she has above-average Medicaid costs. The objective of the individualized threshold calculation is to determine if the individual has earnings sufficient to replace all the benefits that he or she would actually receive in the absence of those earnings. Obviously, for individuals with unusually high Medicaid costs, they would need a higher amount of earned income to replace the Medicaid coverage. In addition, when Social Security is evaluating income for threshold determinations, it’s required to consider any Impairment Related Work Expenses (IRWE) or Work Expenses (BWE) the person has, as well as income excluded under an approved PASS. In some instances, applying these income exclusions may lower countable income below the standard threshold amount, thus allowing an individual to retain Medicaid eligibility under 1619(b) even though gross earnings exceed the state’s charted threshold amount. Finally, Social Security considers the value of publicly funded (other than Medicaid) personal or attendant care the individual receives when making a threshold determination. Social Security recognizes that some SSI recipients may require attendant care services to assist with essential work-related or personal care functions. For purposes of determining Section 1619(b) eligibility, attendant care (including personal care and other domestic assistance and supportive services) means assistance with: Work-related functions; and
The current threshold amounts for each state are shown in the POMS at: Social Security revises charted threshold amounts on an annual basis. If Social Security determines the individual’s countable earned income for the 12-month period is equal to or less than the threshold amount shown on the chart, he or she meets this threshold requirement. 1619(b) Individualized Threshold Amounts If an individual has gross earnings above the charted threshold amount for the state, Social Security can look to see if the agency should calculate a higher individualized threshold. A person may get a higher individualized threshold amount if he or she has above-average Medicaid costs. The objective of the individualized threshold calculation is to determine if the individual has earnings sufficient to replace all the benefits that he or she would actually receive in the absence of those earnings. Obviously, for individuals with unusually high Medicaid costs, they would need a higher amount of earned income to replace the Medicaid coverage. In addition, when Social Security is evaluating income for threshold determinations, it’s required to consider any Impairment Related Work Expenses (IRWE) or Work Expenses (BWE) the person has, as well as income excluded under an approved PASS. In some instances, applying these income exclusions may lower countable income below the standard threshold amount, thus allowing an individual to retain Medicaid eligibility under 1619(b) even though gross earnings exceed the state’s charted threshold amount. Finally, Social Security considers the value of publicly funded (other than Medicaid) personal or attendant care the individual receives when making a threshold determination. Social Security recognizes that some SSI recipients may require attendant care services to assist with essential work-related or personal care functions. For purposes of determining Section 1619(b) eligibility, attendant care (including personal care and other domestic assistance and supportive services) means assistance with: Work-related functions; and
Understanding%201619(b)%202018.docx