Section 1619(b) is one of the most valuable and least-understood protections in the SSI program. It lets you keep your Medicaid coverage even after your earnings push your SSI cash payment all the way down to zero. If you have SSI and are starting to work, or are already working and worried about losing health coverage, this provision may be the bridge that keeps you covered.
The Social Security Administration updated the 2026 thresholds in January 2026. Depending on your state, you can earn anywhere from roughly $40,000 to over $84,000 per year and still qualify. Here is what the rules actually say, how the thresholds work, and what you need to do to stay protected.
What Section 1619(b) Does
Under normal SSI rules, your monthly cash payment shrinks as your earned income rises. Once your earnings get high enough, the payment drops to zero and your SSI case closes. In most programs, losing eligibility means losing Medicaid too.
Section 1619(b) breaks that link. If you were receiving SSI and your earnings eventually zero out your cash payment, you can remain eligible for Medicaid as long as your gross annual earnings stay below your state's threshold and you still meet the other requirements.
This matters enormously for people with disabilities who rely on Medicaid for ongoing medical care, prescriptions, personal attendant services, or mental health treatment. Losing that coverage is often the single biggest barrier to taking a job or increasing hours.
2026 Eligibility Requirements
To qualify under Section 1619(b) in 2026, you must meet all of the following:
- You received at least one SSI cash payment in or after July 1987 (this is a lifetime requirement, not a monthly one)
- You still meet SSA's disability or blindness definition
- Your countable resources are under $2,000 (or $3,000 for an eligible couple)
- Your gross annual earnings are below your state's 2026 threshold
- You have used Medicaid in the past 12 months, expect to use it in the next 12 months, or would be unable to afford your medical expenses without it
The Medicaid-use requirement is often overlooked. If you go a full year without using any Medicaid-covered services and do not anticipate needing them soon, SSA may determine that your earnings are sufficient to replace the value of your coverage, which would end your 1619(b) eligibility.
2026 State Thresholds
The threshold is the maximum gross annual earnings you can have and still qualify for 1619(b) Medicaid in your state. SSA calculates each state's threshold based on the average Medicaid costs for SSI recipients in that state, plus the SSI federal benefit rate and earned income disregards.
States with higher average Medicaid expenditures per beneficiary have higher thresholds. That is why Minnesota sits at $84,208 and Alabama sits at $40,026.
| State | 2026 Threshold |
|---|
| Alabama | $40,026 |
| Alaska | $73,070 |
| Arizona | $59,182 |
| Arkansas | $40,366 |
| California | $66,078 |
| Colorado | $63,454 |
| Connecticut | $55,480 |
| Delaware | $60,163 |
| District of Columbia | $73,901 |
| Florida | $42,946 |
| Georgia | $41,927 |
| Hawaii | $51,832 |
| Idaho | $53,625 |
| Illinois | $47,756 |
| Indiana | $47,397 |
| Iowa | $53,732 |
| Kansas | $54,547 |
| Kentucky | $48,099 |
| Louisiana | $44,804 |
| Maine | $56,143 |
| Maryland | $62,929 |
| Massachusetts | $52,015 |
| Michigan | $42,987 |
| Minnesota | $84,208 |
| Mississippi | $43,992 |
| Missouri | $55,181 |
| Montana | $49,174 |
| Nebraska | $56,282 |
| Nevada | $47,006 |
| New Hampshire | $50,485 |
| New Jersey | $63,400 |
| New Mexico | $54,557 |
| New York | $68,654 |
| North Carolina | $51,178 |
| North Dakota | $60,145 |
| Ohio | $50,138 |
| Oklahoma | $46,831 |
| Oregon | $47,856 |
| Pennsylvania | $55,023 |
| Rhode Island | $46,819 |
| South Carolina | $44,963 |
| South Dakota | $53,537 |
| Tennessee | $41,797 |
| Texas | $53,165 |
| Utah | $54,668 |
| Vermont | $52,699 |
| Virginia | $63,537 |
For Washington, West Virginia, Wisconsin, Wyoming, and the Northern Mariana Islands, refer to SSA POMS SI 02302.200 for the current threshold, as those figures were not included in publicly available 2026 summary tables at time of publication.
Special Thresholds for Blind Recipients
Four states maintain a separate, higher threshold for individuals who qualify for SSI on the basis of blindness rather than disability:
| State | Blind Threshold 2026 |
|---|
| California | $68,103 |
| Iowa | $54,260 |
| Massachusetts | $52,864 |
| Nevada | $49,629 |
If you are in one of these four states and receive SSI based on blindness, use the blind threshold, not the disability threshold.
What Happens When Your Earnings Exceed the Threshold
Exceeding your state's standard threshold does not automatically disqualify you. SSA can calculate an individualized threshold that accounts for your specific situation. Your personal threshold may be higher than the standard one if you have:
- Impairment-related work expenses (IRWEs) such as medications, equipment, or transportation costs directly tied to your disability and required to work
- Blind work expenses (BWEs) if you receive SSI based on blindness
- A Plan to Achieve Self-Support (PASS) that sets aside income for a work goal
- Publicly funded personal attendant services
- Unusually high Medicaid costs compared to the state average
To request an individualized threshold calculation, contact your local SSA field office. Bring documentation of your disability-related expenses. The calculation is not automatic and you need to ask for it.
How Section 1619(b) Works in Practice
When your SSI cash payment goes to zero because of earnings, SSA's computer system is designed to automatically evaluate your 1619(b) status. In practice, that automatic check does not always happen reliably, and your Medicaid coverage can lapse if nothing flags the transition.
Here is what to do to protect yourself:
Step 1: Report your earnings to SSA every month. Call 1-800-772-1213 or visit your local SSA field office. You can also report via My Social Security at ssa.gov. Monthly reporting is required and keeps SSA's records accurate.
Step 2: When your payment drops to zero, notify SSA in writing. Ask them to document your 1619(b) status explicitly. Do not assume the system caught it.
Step 3: Also notify your state Medicaid agency. SSA handles the eligibility determination, but your state Medicaid office controls the actual coverage. Tell them you are continuing under Section 1619(b) so they do not terminate your enrollment.
Step 4: Keep your resources below $2,000. This is a hard limit. If your countable resources exceed $2,000 at any point, you lose both SSI and 1619(b) eligibility. Bank accounts, certain investment accounts, and cash are countable. Your primary home, one vehicle used for transportation, and certain other items are excluded.
Step 5: Keep a record of your Medicaid use. If you have not used Medicaid services in the past year, contact your local benefits counselor or SSA to confirm your status. Document any expected medical needs.
Section 1619(a) vs. Section 1619(b)
These two provisions are related but different.
Section 1619(a) applies when you are working but your earnings are not high enough to fully offset your SSI payment. Under 1619(a), SSA continues to pay a small SSI amount even after your income would normally disqualify you, and your Medicaid continues automatically.
Section 1619(b) takes over once your earnings are high enough that your SSI payment reaches zero. At that point, 1619(a) no longer applies, but 1619(b) lets you keep Medicaid even without any cash benefit.
In short: 1619(a) is for people whose SSI is reduced but not zeroed out. Section 1619(b) is for people whose SSI payment has hit zero entirely.
Other SSI Work Incentives to Know About
Section 1619(b) works best when combined with other SSI work incentives:
Earned Income Exclusion: SSA excludes the first $65 of monthly earned income, then counts only half of the remainder. This significantly slows how fast your SSI payment drops as you earn more.
Trial Work Period: SSI does not have a formal Trial Work Period like SSDI, but the earned income exclusion effectively allows you to test employment without an immediate full loss of benefits.
PASS (Plan to Achieve Self-Support): A PASS allows you to set aside income or resources for a specific work goal, such as education, training, or starting a business. Money in a PASS does not count against your resource limit.
Ticket to Work: A voluntary SSA program that connects SSI and SSDI beneficiaries with employment services, vocational rehabilitation, and benefits counseling at no cost.
If you are approaching your state's 1619(b) threshold and want to keep working, a Work Incentives Planning and Assistance (WIPA) counselor can help you map out your options. WIPA services are free and funded by SSA.
A Note on Medicaid Expansion States
Section 1619(b) applies in all states, but your state's overall Medicaid program structure matters too. In Medicaid expansion states, working adults without disabilities may qualify for Medicaid through the expansion pathway at incomes up to 138% of the federal poverty level. However, if you receive SSI, you typically fall under a different Medicaid eligibility category and the 1619(b) threshold is what governs your continued coverage, not the expansion income limit.
Use our free benefits screener to check your full eligibility picture across SSI, Medicaid, and other programs based on your state and income.
Frequently Asked Questions
What is the 1619(b) threshold for my state in 2026?
The 2026 thresholds range from $40,026 in Alabama to $84,208 in Minnesota. See the full table above for your state's specific amount. If your state is not listed, check SSA's POMS SI 02302.200 or call SSA at 1-800-772-1213.
Does Section 1619(b) apply automatically, or do I have to apply?
It is supposed to be automatic. When your SSI cash payment drops to zero, SSA's system should flag you for 1619(b) review. In practice, errors happen. You should proactively notify SSA and your state Medicaid office when your earnings zero out your cash payment, and ask for written confirmation of your 1619(b) status.
Can I lose 1619(b) eligibility if I do not use Medicaid?
Yes. If you have not used Medicaid in the past 12 months and do not expect to need it and could afford your medical expenses without it, SSA may determine your earnings are sufficient to replace the value of your Medicaid. This is rare but possible. If you rarely use services, document any anticipated needs.
What if my earnings go above my state's threshold?
Ask SSA to calculate an individualized threshold. Your personal threshold may be higher than the standard amount if you have significant disability-related work expenses, a PASS, or unusually high medical costs. The individualized calculation is not automatic. You must request it.
Does 1619(b) protect my Medicaid forever?
As long as you meet all the requirements each year, yes. SSA reviews 1619(b) eligibility annually. You need to continue meeting the disability standard, keep resources below $2,000, keep earnings below your threshold, and have a continuing Medicaid need.
Will getting a raise push me off 1619(b)?
Only if it pushes your gross annual earnings above your state's threshold and you do not qualify for an individualized threshold. A raise that keeps you below your state's cap has no effect on your 1619(b) status.
What is Section 1619(b) for blind recipients?
If you receive SSI based on blindness rather than disability, you use a different income exclusion formula (Blind Work Expenses instead of IRWEs), and four states use a separate higher threshold for blind recipients. California, Iowa, Massachusetts, and Nevada all have distinct blind thresholds. Check the table above.
Where can I get free help understanding my SSI work incentives?
SSA funds Work Incentives Planning and Assistance (WIPA) programs in every state. WIPA counselors provide free, individualized benefits counseling for SSI and SSDI recipients who are working or considering work. Find your local WIPA at choosework.ssa.gov.
