She’ll Take a Full-Time Remote Job and Lose Her SSI Check. Ohio Could Let Her Keep Medicaid With Earnings Up to $50,138 a Year

Working from home explains 68% to 85% of the post-pandemic rise in full-time employment among people with physical disabilities, according to the working paper Work from Home and Disability Employment. The research found that a 1-percentage-point increase in remote work raised full-time employment for that group by 1.0%.

The opportunity comes with a benefits question. Picture a woman in Ohio with a spinal cord injury who answers customer-service tickets from her kitchen table. Her manager offers her full-time hours. She runs the numbers, sees that her Supplemental Security Income (SSI) check will disappear and fears her Medicaid card will go with it. A federal protection allows many workers in her position to keep Medicaid even after their earnings become too high for an SSI cash payment.

How Section 1619(b) Keeps Medicaid After the SSI Check Stops

Once someone goes to work, SSI cash and Medicaid follow separate rules. Under Section 1619(b) of the Social Security Act, a worker keeps Medicaid if she received an SSI cash payment for at least 1 month, still meets the disability requirement and SSI’s other rules, needs Medicaid to keep working, and makes too little to replace SSI, Medicaid and any publicly funded attendant care.

The SSI asset limit still applies. In 2026 it’s $2,000 for an individual and $3,000 for a couple, the same as in 2025. Savings that pile up in checking can cost her coverage faster than the raise itself.

It helps to keep SSI and Medicaid straight. SSI provides monthly cash benefits to qualifying people with limited income and resources, while Medicaid provides health coverage. Many SSI recipients qualify for Medicaid through their SSI status, and 1619(b) can preserve that Medicaid after earnings become too high for the cash benefit.

Her SSI Check Can End Near $2,073 a Month While Ohio’s Medicaid Threshold Runs to $50,138

Track the cash and the health coverage separately. For the cash benefit, SSA ignores a $20 general income exclusion, then the first $65 of monthly earnings and one-half of the earnings in excess of $65. The 2026 federal SSI payment is $994 a month, so a worker with no other income loses the federal check at about $2,073 a month in gross pay. In states that add their own SSI supplement, the check stops at a higher income.

Say her full-time remote job pays $2,600 a month, or $31,200 a year. SSA counts $1,257.50 of that as income. That’s more than the $994 benefit, so her SSI check stops.

Her health coverage runs on a different formula. SSA sets a 1619(b) threshold for each state based on the earnings that stop SSI cash payments in that state and average Medicaid expenses there. Ohio’s 2026 threshold is $50,138. Her $31,200 falls well below it, so her Medicaid continues.

The thresholds vary widely by state. The 2026 figure is $40,026 in Alabama, $68,654 in New York and $84,208 in Minnesota. A worker who makes more than her state’s threshold can still get an customized threshold if she has impairment-related work expenses, a publicly funded personal attendant or medical expenses above her state’s average.

When Pay Tops Ohio’s Standard Threshold, Another Medicaid Path May Open

Suppose she gets a promotion and her pay rises past $50,138. That does not automatically end 1619(b), because SSA can calculate a higher individualized threshold. If she no longer qualifies, Ohio offers another path: Medicaid Buy-In for Workers with Disabilities (MBIWD).

Ohio sets the program’s countable-income standard at 250% of the federal poverty level, or $3,325 a month for one person in 2026. MBIWD applies substantial income exclusions. Disability Benefits 101 Ohio says a worker with no unearned income could earn as much as $120,820 a year and still qualify.

Each state establishes its own buy-in rules. These programs let qualifying workers with disabilities keep Medicaid at higher earnings, sometimes with a premium. In 2026, 47 states offer a buy-in pathway, but program names, premiums, asset tests and income limits differ widely.

Three Checks Before Turning Down Full-Time Hours

Before she turns down the extra hours, she has three things to look up:

1. Her state’s 2026 1619(b) threshold, which SSA posts online, and whether her medical or work expenses qualify her for a higher customized threshold.
2. Her state’s Medicaid buy-in rules, including the income limit, premiums and asset test, in case her pay keeps rising.
3. The reporting rules from both SSA and her state Medicaid agency. Wages she doesn’t report can lead to overpayment notices that show up months later, often with a repayment demand attached.

Remote work made the full-time job possible. For many workers, federal protections that let certain former SSI recipients keep Medicaid, or a state buy-in program, mean earning more does not have to mean losing coverage.

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