Health Care Work Incentives

If you get health care benefits like Medicare or Arizona Health Care Cost Containment System (AHCCCS) coverage, there are also incentives that make sure you continue to have good health coverage after you get a job.

Medicare

Many people with disabilities get Medicare health coverage, usually because they also get Social Security Disability Insurance (SSDI). If your income goes up while you’re on SSDI, your benefits can go down, though the work incentives described earlier in this article can help you to gradually try out working without fear of suddenly losing your cash benefits. Likewise, you can gradually try out working without fear of suddenly losing your Medicare coverage, thanks to the incentives described here.

Continuation of Medicare Coverage

Once you become eligible for Medicare, you can continue getting Medicare coverage for at least 93 months (or 7 years and 9 months) after your SSDI Trial Work Period (TWP) ends, if you are still disabled under Social Security’s guidelines. The 93-month period starts the month after the last month of your TWP.

To learn more, read DB101’s article on Medicare or talk to a Work Incentive Consultant.

Medicare for Persons with Disabilities Who Work

If you are still working after your Continuation of Medicare Coverage period ends, you may be able to buy continued Medicare coverage. You are eligible to buy Medicare coverage if:

• You are under age 65
• You continue to be disabled
• Your Medicare stopped because of work

For more information about buying Medicare continuation coverage, visit Medicare’s website or call them at 1-800-633-4227 or 1- 877-486-2048 (TTY). The line is open 24 hours a day, 7 days a week. You can also talk to a Work Incentive Consultant.

The Arizona Health Care Cost Containment System (AHCCCS)

Many people with low income get Arizona Health Care Cost Containment System (AHCCCS) health coverage. Some worry that if they make too much money or save up too much, they'll lose their health coverage. However, there are work incentives that mean that if you are getting AHCCCS now and get a job, you’ll still be able to get good health coverage.

AHCCCS Freedom to Work

If you have a disability, you may qualify for AHCCCS Freedom to Work if your income is $6,360 per month or less, depending on your situation and the types of income you have. AHCCCS Freedom to Work lets you keep your AHCCCS coverage by paying a small premium.

To qualify for AHCCCS Freedom to Work you must:

• Be age 16 – 65
• Be an Arizona resident
• Be a United States citizen or a qualified immigrant
• Be working and paying taxes
• Have a Social Security number or apply for one
  • To apply for a Social Security number, visit the U.S. Social Security Administration
  • Make a copy of the form submitted as confirmation that you have applied for a Social Security number
• Apply for potential income that may be available, such as unemployment, pension, and Social Security disability benefits
• Get Social Security disability or be considered blind or disabled by the Disability Determination Services Administration (DDSA)
• Not be eligible for any other AHCCCS program
• Have $6,360 in monthly income or less per month. Whether your income is low enough will depend on your situation and what types of income you have.

You must pay a monthly premium for AHCCCS Freedom to Work coverage. The premium is based on your income and household size, with a maximum premium of $35 per month.

AHCCCS Freedom to Work pays for things like visits to the doctor, hospital stays, medical equipment, home care services, and mental health services.

1619(b)

If you’re on Supplemental Security Income (SSI), 1619(b) lets you keep your health care coverage through AHCCCS, even when your earnings are too high for SSI cash benefits. You can earn up to $53,159 a year and keep your AHCCCS coverage.

To qualify, you must:

• Have been eligible for SSI cash benefits for at least 1 month
• Would be eligible for cash benefits if it weren’t for your earnings
• Still be disabled
• Still meet all other eligibility rules, including the SSI resource limit ($2,000 if you’re single, $3,000 for couples)
• Need AHCCCS to work
• Have gross annual earned income that is below $53,159

If your gross earnings are higher than $53,159 you may still be eligible if you have:

• Impairment Related Work Expenses (IRWEs)
• Blind Work Expenses (BWEs)
• A Plan to Achieve Self-Support (PASS)
• Publicly funded attendant or personal care

To learn more, talk to a Work Incentive Consultant.

Subsidized Individual Coverage Through HealthCare.gov

If your income is too high to qualify for AHCCCS, you should be able to buy individual health coverage through HealthCare.gov. The government may help you pay for your monthly premium through tax credits. If your family's income is at or below 250% of the Federal Poverty Guidelines (FPG), the government may also help you get a plan that has lower copayments and other expenses.

Note: There is no income limit for getting subsidies that help pay individual coverage premiums. (Before 2021, the limit was 400% of FPG.) To get subsidies, you still must meet other eligibility rules and the premium amount you pay depends on your income and your plan.

To learn more, read DB101's article on Buying Health Coverage on HealthCare.gov.