Even With a Disability, Work is Within Reach

Employment is more than a paycheck—it’s about independence, dignity, and opportunity—and OSCIL wants all Rhode Islanders to know that work, disability, and financial security are possible, even if you depend on benefits or services to meet your daily needs. This Disability Employment Awareness Month, we’re promoting inclusive employment practices that empower everyone to thrive, and sharing valuable resources to support your employment goals.

Work & Disability Benefits: Did you know?

SSI recipients who go to work may still qualify for Medicaid coverage under SSA’s 1619(b) work incentive, even if their income exceeds the SSI limit. In Rhode Island, that’s $43,226 per year or about $20/hr for a full-time employee, but even if you earn more you may still qualify through an individual threshold based on your actual Medicaid expenses (including waiver services like PCA).

The bottom line:

The benefit of 1619(b) is that your Medicaid coverage remains cost-free, and if you have high Medicaid costs like expensive medications, durable medical equipment, or PCA services and individual threshold can permit a much higher allowable income.

However, you still need to meet the rest of the SSA’s eligibility rules, including completing medical eligibility recertifications, having less than $2000, and not having retirement accounts or cashable life insurance. Importantly, 1619(b) does not apply to spousal income, so it generally will not protect your Medicaid coverage if you are married.

Rhode Island Has Other Options

Maybe you’re earning too much, plan to save for retirement, or want to get married. Whatever the reason, if 1619(b) doesn’t work for you, Rhode Island has another option.

Ticket to Work (don’t confuse it with Social Security’s program of the same name) allows Rhode Islanders with significant disabilities to “buy in” to Medicaid by paying a monthly fee based on your income. Ticket to Work is for people under age 65 and has no income or asset limits. For people 65+, the Sherlock Plan protects Medicaid benefits for people who have less than $10,000 ($20,000 for a couple) and earn less than $76,308. Click here to learn more about the Sherlock Plan & Ticket to Work.

The bottom line:

Ticket to Work gives you more freedom to earn and save money as you wish and get married without losing critical benefits. The Sherlock Plan does the same for older adults, but with some limits. However, your Medicaid will no longer be free; on either of these plans you will have to make a monthly payment to keep your coverage.

If you are on Ticket to Work and have more assets or retirement savings, you may need to plan for when you reach age 65 because eligibility for the Sherlock Plan is more restrictive. You may want to speak with an estate planning lawyer who is familiar with Medicaid and Social Security. There are some options, but we’re not experts and it is too complicated to talk about here!

Want to find out what work incentives will work best for you?

The Sherlock Center offers benefits counseling to help navigate work incentives and employment supports.