Two provisions in the Social Security Act, Sections 1619(a) and 1619(b), exist specifically to remove the all-or-nothing fear that stops many SSI recipients from working. Under these rules, you can earn more, even above the Substantial Gainful Activity (SGA) level in some situations, without automatically losing your SSI cash payment or your Medicaid coverage. In 2026, both protections remain in place, and the thresholds that determine eligibility have been updated to reflect current Medicaid costs. This guide explains how each provision works, what the 2026 numbers look like, and what you need to do to stay covered.
What Is Section 1619(a)?
Section 1619(a) protects your SSI cash payment while you are working. Normally, earning income reduces your SSI benefit dollar for dollar after standard disregards are applied. The standard formula works like this: SSA ignores the first $20 of any income, ignores the first $65 of earned income, then reduces your benefit by $1 for every $2 you earn above that.
Under 1619(a), even if your countable earnings are high enough to trigger an SGA finding, SSA will not use SGA to terminate your cash benefits while you remain in SSI status. Your benefit will continue to shrink as earnings rise, following the standard calculation, until it reaches zero. You do not hit a sudden cutoff.
Who Qualifies for 1619(a)?
To use 1619(a), you must meet all of the following:
- You received at least one SSI cash payment before your earnings increased
- You still meet SSA's medical disability standard
- You meet all other SSI eligibility rules, including the resource limit ($2,000 for individuals, $3,000 for couples in 2026)
There is no time limit on how long you can use 1619(a). It applies for as long as your earnings keep your SSI payment above zero and you continue meeting the requirements.
How Impairment-Related Work Expenses Help
If you pay out of pocket for items or services required because of your disability in order to work, those costs count as Impairment-Related Work Expenses (IRWEs). SSA deducts IRWEs from your gross earnings before doing the SGA calculation and the benefit reduction calculation. Common examples include:
- Wheelchair or other mobility equipment
- Specialized transportation to and from work
- Adaptive technology or software used on the job
- Attendant care needed specifically for work
Documenting IRWEs carefully can lower your countable earned income significantly, which both preserves more of your SSI cash payment and makes it easier to remain under the relevant thresholds.
What Is Section 1619(b)?
Section 1619(b) picks up where 1619(a) leaves off. When your earnings grow large enough that your SSI cash benefit drops to zero, you might expect Medicaid to end at the same moment. That is not how it works. Under 1619(b), SSA can reclassify you as eligible for SSI for Medicaid purposes only. You stop receiving a cash check, but your Medicaid card stays active.
This matters enormously for people with significant medical needs. Losing Medicaid often means losing access to prescription coverage, specialist care, or personal care attendants that make employment possible in the first place.
Five Requirements to Keep 1619(b) Protection
You must meet all five conditions:
- Prior SSI cash receipt. You received at least one month of SSI cash benefits before your income increased past the payment threshold.
- Continued disability. You still meet SSA's medical standards for disability.
- Resource limit. Your countable resources stay at or below $2,000 for an individual or $3,000 for a couple.
- Medical necessity. Without Medicaid, you would be unable to continue working, because the value of coverage and related services exceeds what you could replace on your own.
- Earnings below your state's threshold. Your gross earned income must stay below your state's calculated 1619(b) threshold amount.
There is no time cap. As long as you keep meeting these conditions, your Medicaid protection through 1619(b) continues indefinitely.
2026 Income Thresholds by State
The 1619(b) threshold for each state is computed by SSA using a formula that adds together your state's base SSI rate, any state supplemental payments, and the average per-capita Medicaid expenditure in your state. States where Medicaid spending per recipient is higher produce higher thresholds, which means you can earn more before losing coverage. SSA updates these figures annually. The 2026 figures use the most recent available Medicaid expenditure data.
The range in 2026 runs from approximately $29,412 in the Northern Mariana Islands up to $84,208 in Minnesota.
| State | 2026 Threshold (Disabled) |
|---|
| Alabama | $40,026 |
| California | $66,078 |
| Florida | $42,946 |
| Illinois | $47,756 |
| Minnesota | $84,208 |
| New York | $68,654 |
| Texas | $53,165 |
| Washington | $73,897 |
Four states publish a separate, higher threshold for individuals who are blind: California ($68,103), Iowa ($54,260), Massachusetts ($52,864), and Nevada ($49,629).
For states not listed above, the threshold is typically in the $40,000 to $55,000 range depending on that state's Medicaid costs. SSA publishes the complete list in POMS SI 02302.200, which is updated each January.
Individualized Threshold Calculations
If your earnings approach or exceed the standard state threshold, do not stop there. SSA can calculate a personalized threshold that is higher than the published figure when you have significant:
- Impairment-related work expenses
- Blind work expenses
- Plan to Achieve Self-Support (PASS) amounts
- Attendant care or personal assistant costs tied to employment
Request an individualized threshold calculation through your local SSA field office or by working with a Work Incentive Planning and Assistance (WIPA) counselor.
How 1619(a) and 1619(b) Work Together
Think of them as two consecutive safety nets. When you start working and earning income, 1619(a) lets your SSI cash payment shrink gradually rather than cutting off at SGA. As earnings climb higher, the cash benefit eventually hits zero. At that point, 1619(b) steps in to preserve your Medicaid as long as your total earnings stay below your state's threshold.
Here is a simplified picture of how benefits shift as income rises:
| Earnings Level | Cash Benefit | Medicaid |
|---|
| Below break-even point | Reduced SSI cash payment | Active |
| Above break-even, below state threshold | $0 (1619(b) status) | Active |
| Above state threshold | $0 | Ends unless exception applies |
If your earnings later drop back below the break-even point, your cash SSI payment restarts automatically. You do not need to reapply.
Reporting Requirements
Using 1619(a) or 1619(b) does not suspend your obligation to report earnings to SSA. You must report wages within 10 days of the end of the month in which you were paid. Failure to report can lead to overpayments that SSA will seek to recover.
You can report wages:
- Online through the SSA mobile wage reporting app
- By phone through SSA's automated reporting line
- In person at your local SSA field office
- By mailing pay stubs to SSA
If you are unsure whether a particular payment counts as earned income for SSI purposes, contact SSA or a WIPA counselor before assuming it does not.
What Happens if You Exceed the 1619(b) Threshold?
If your earnings go above your state's threshold, you lose 1619(b) protection and Medicaid ends. However, there are a few important safeguards:
- Expedited reinstatement. If your income later drops below the threshold, you can request reinstatement of 1619(b) status without a full new application, as long as you still meet the disability criteria.
- Medicaid Buy-In programs. Many states run Medicaid Buy-In programs for working adults with disabilities, sometimes called Medicaid for Workers with Disabilities. These programs allow higher earners to purchase Medicaid coverage at a sliding-scale premium. If you exceed the 1619(b) threshold, a Buy-In program may fill the gap.
- Marketplace coverage. If you are earning enough to exceed the threshold, you may qualify for subsidized ACA Marketplace coverage depending on your income relative to the Federal Poverty Level.
Plan to Achieve Self-Support (PASS)
A PASS allows you to set aside income or resources for a specific vocational goal, such as education, job training, or starting a small business. Amounts set aside under an approved PASS are excluded from the income and resource calculations SSA uses for SSI, which can effectively lower your countable income and preserve both cash payments and 1619(b) status while you invest in building long-term earning capacity.
PASS plans require SSA approval and must specify a realistic work goal with a defined timeline. Contact your SSA field office or a WIPA counselor to learn whether a PASS makes sense for your situation.
Where to Get Free Help
Navigating 1619(a) and 1619(b) involves multiple moving pieces: earnings calculations, IRWE documentation, threshold comparisons, and reporting timelines. Several free resources exist:
- WIPA programs. Work Incentive Planning and Assistance counselors are funded by SSA to help SSI and SSDI recipients understand how work affects benefits. Find your local WIPA at choosework.ssa.gov.
- Benefits counselors at Centers for Independent Living. Many CILs employ staff who can walk through your specific numbers with you.
- SSA field offices. While wait times vary, your local office can answer questions about your particular case and calculate your current threshold.
You can also use the Benefits Navigator screener at benefitsusa.org/screener to check your current SSI eligibility and see which other programs you may qualify for as your income changes.
Frequently Asked Questions
What is the difference between 1619(a) and 1619(b)?
Section 1619(a) keeps your SSI cash payment active even when earnings are high, reducing it gradually rather than cutting it off at the SGA level. Section 1619(b) preserves your Medicaid after your cash payment has dropped to zero, as long as your earnings stay below your state's threshold. They are sequential: 1619(a) applies first, and 1619(b) takes over when cash benefits end.
Do I have to apply for 1619(a) or 1619(b) separately?
No. Both protections apply automatically if you meet the eligibility conditions. You do not file a separate application. However, you must continue reporting your earnings to SSA so they can correctly apply the rules to your case.
What is the 2026 SSI maximum federal payment?
The 2026 federal SSI payment is $994 per month for an eligible individual and $1,491 per month for an eligible couple. Some states add a supplementary payment on top of the federal amount.
What is the SGA limit in 2026?
In 2026, the Substantial Gainful Activity limit is $1,690 per month for non-blind recipients and $2,830 per month for blind recipients. For SSI (unlike SSDI), exceeding SGA does not automatically terminate benefits if you remain in 1619(a) status and still meet eligibility criteria.
Can I lose 1619(b) status if I take a break from work?
If you stop working and your earnings drop to zero, SSA will review whether you still meet all 1619(b) conditions. If your income falls below the break-even point for regular SSI cash payments, your cash benefit will typically restart. Talk to SSA before making significant changes to your work schedule to understand how it will affect both payments and Medicaid.
Are there states where 1619(b) does not apply?
A small number of states use a different Medicaid eligibility determination system called 209(b), which may have stricter rules than standard 1619(b) provisions. In these states, you may need to separately meet the state's Medicaid criteria even if you qualify under federal 1619(b) rules. Check with your state Medicaid agency or a WIPA counselor if you are in a 209(b) state.
How long can I stay on 1619(b)?
There is no time limit. You can use 1619(b) protection indefinitely as long as you continue meeting all five eligibility requirements: prior SSI receipt, ongoing disability, resource compliance, medical necessity of Medicaid for work, and earnings below the state threshold.
What happens to my Medicare if I also have SSDI?
These rules apply to SSI and Medicaid specifically. If you also receive SSDI, separate rules govern your Medicare coverage, including the Trial Work Period and Extended Period of Eligibility. SSDI work incentives and SSI work incentives overlap but are not identical. A WIPA counselor can review your full benefit picture if you receive both.
Where can I find the current threshold for my state?
SSA publishes the complete state-by-state threshold list in its Program Operations Manual System (POMS) at SI 02302.200, updated each January. You can also ask your SSA field office to tell you your current threshold or request an individualized calculation if you have significant work expenses.
