2.3.8 Medical Assistance 1619(a) or 1619(b)(Archive)

Supplemental Security Income (SSI) is a federal program administered by the Social Security Administration (SSA) that provides monthly cash payments to people age 65 or older and people who are or certified blind or disabled and have little or no income.

SSI has a work incentive provision under section 1619 of the Social Security Act for people whose earnings reduces or eliminates their SSI cash benefit. People who are eligible for SSI under section 1619 are eligible for Medical Assistance (MA) without regard to their income or assets. 1619(a) is for people who receive a partial SSI cash benefit. 1619(b) is for people who no longer receive an SSI cash benefit.

This page outlines the general, financial, non-financial, and post eligibility requirements for people under a 1619(a) or 1619(b) status. It describes policies that apply to MA-1619(a) and 1619(b) and links to policies that apply to all MA programs, MA for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD), and all Minnesota Health Care Programs (MHCP) programs.

1.  General Requirements

   1. MA Applications

   2. People currently enrolled in MA who gain 1619(a) or 1619 (b) status are not required to submit a new application to continue MA eligibility. People not currently enrolled in MA who gain 1619(a) or 1619(b) status must submit a new application to apply for MA. Refer to Section 1.2 Minnesota Health Care Programs (MHCP) Applications for more information about applications.

   3. MA Responsibilities

      1. MA Benefit Recovery

         1. MA Estate Recovery

         2. MA Liens

         3. MA Third Party Liability

         4. MA Cost Effective Insurance

         5. MA Medical Support

         6. MA Other Third Party Liability

      2. MA Cooperation

      3. MA Cost Sharing

      4. MHCP Fraud

      5. MHCP Inconsistent Information

      6. MA Referral for Other Benefits

   4. MHCP Rights

      1. MHCP Appeals

      2. MHCP Authorized Representative

      3. MHCP Civil Rights

      4. MHCP Data Privacy

      5. MHCP Notices

2.  Non-Financial Eligibility

   1. To be eligible for 1619(a) or 1619(b), the person must:

      • be eligible for a regular SSI payment based on disability for at least one month before he or she earned income above the SSI limit;

      • continue to have a disability or blind status; and

      • continue to meet all other SSI eligibility criteria except for earnings

   2. To be eligible for 1619(b), a person must:

      • Need MA coverage to continue working; and

      • Not have sufficient earnings to replace SSI cash benefits, MA benefits, and publicly funded personal or attendant care services that would be lost due to the person’s earnings.

   3. MA-ABD Non-Financial Eligibility

3.  Financial Eligibility

   1. People are eligible without an asset test as long as they remain under the 1619(a) or 1619(b) status. SSA decides when a person exceeds the 1619(a) or 1619(b) asset limit.

   2. People are eligible without an income test as long as they retain 1619(a) or 1619(b) status. SSA decides when a person exceeds the income limit.

   3. See the SSA Continued Medicaid Eligibility web page for more information.

4.  Post-Eligibility

   1. MA Benefit Recovery

      1. MA Estate Recovery

      2. MA Liens

      3. MHCP Overpayments

      4. MA Third Party Liability

      5. MA Cost-Effective Insurance

      6. MA Medical Support

      7. MA Other Third Party Liability

   2. MHCP Change in Circumstances

   3. MA Cooperation

   4. MA Cost Sharing

   5. MHCP Fraud

   6. MA-ABD Health Care Delivery

   7. MHCP Inconsistent Information

   8. MA Qualifying Health Coverage

   9. MA Referral for Other Benefits

   10. MA-ABD Renewals

DHS pays Medicare Part B premiums for 1619(a) and 1619(b) recipients enrolled in Medicare and receiving Retirement, Survivors, or Disability Insurance (RSDI) benefits.

Legal Citations

Minnesota Statutes, section 256B.056, subdivision 1a

Social Security Act, section 1619

Published:  August 1, 2017

Archived: June 1, 2020