Georgia Section 1619(b) 2026: Keep Medicaid When Working

Georgia Section 1619(b) lets working former SSI recipients keep full Medicaid until gross earnings pass $41,927 a year in 2026.1 It is the Social Security work incentive that keeps Medicaid in place even after the Supplemental Security Income (SSI) cash payment stops, protecting the prescriptions, doctor visits, and home and community-based waiver services that make holding a job possible. Section 1619(b) is a federal rule that SSA develops in every state, but the earnings ceiling is set state by state.2

In This Guide

• Who Qualifies for Georgia Section 1619(b)?
• The Georgia Section 1619(b) Threshold for 2026
• The Individualized Threshold Above the Charted Amount
• From SSI Cash to 1619(b): How the Switch Works
• Section 1619(b) vs. QDWI
• How Georgia Administers Section 1619(b)
• Work Incentives That Stretch the Threshold
• Worked Examples for Georgia
• What Happens When Section 1619(b) Ends
• Common Mistakes With Georgia Section 1619(b)
• How to Keep Medicaid While Working
• Frequently Asked Questions
• Learn More

Who Qualifies for Georgia Section 1619(b)?

Section 1619(b) of the Social Security Act protects Medicaid for a blind or disabled person who was receiving SSI, went to work, and earned enough that the SSI cash payment stopped. To keep Medicaid under 1619(b), all of the following must be true at the same time.2

• You received SSI in a prior month. You must have been eligible for and have actually received a regular SSI cash payment based on disability in a previous month within your current period of eligibility. It does not have to be the month right before the cash stopped. The pathway is reserved for people moving from SSI to work, not from another loss of eligibility to work.2
• You still meet SSI rules except for earnings. Apart from your higher earnings, you would still qualify for SSI under Section 1611, including the resource limit of $2,000 for an individual and $3,000 for a couple.3
• Your disability or blindness continues. You must still have the impairment on which the disability finding was based. If Social Security determines you no longer have that impairment, 1619(b) ends.2
• You need Medicaid to keep working. This is SSA's Medicaid Use Test, and it is a real screen rather than a formality. You meet it if you used Medicaid in the past 12 months, expect to use it in the next 12 months, or could not pay unexpected medical bills in the next 12 months without it. Answering no to all three produces a finding of ineligibility.2
• Your gross earnings are at or below your Georgia threshold. Gross earned income for the 12-month period being determined must be at or below the Charted Threshold Amount described in the next section. Going over it does not automatically end coverage; SSA then checks you against a higher individualized threshold.1

SSA evaluates these criteria, not the Georgia Department of Community Health, because 1619(b) status flows from the federal SSI program to Georgia Medicaid automatically.

The Georgia Section 1619(b) Threshold for 2026

Georgia's 2026 Section 1619(b) threshold, formally the Charted Threshold Amount, is $41,927 in gross annual earned income.1 Gross earned income at or below that figure satisfies the threshold test, and a working former SSI recipient keeps full Medicaid; above it, SSA's field office checks whether a higher individualized threshold covers you.1

SSA recalculates each state's Charted Threshold Amount every year under its Program Operations Manual System (POMS) section SI 02302.200. The Georgia figure adds two parts.1

• A Base Amount of $24,876, which is the amount of earned income it takes to reduce the annual SSI federal benefit to zero.1
• Georgia's average per-capita Medicaid expense of $17,051 for the SSI-eligible population.1

Added together, $24,876 plus $17,051 produces Georgia's $41,927 standard threshold.1 States with higher average Medicaid spending have higher thresholds; Georgia's reflects moderate per-capita spending for the aged, blind, and disabled population. Each state sets its own Charted Threshold Amount, so the Georgia figure does not carry over if you move. SSA publishes the current table for every state in POMS SI 02302.200.

The Individualized Threshold Above the Charted Amount

Earning more than $41,927 does not by itself end Section 1619(b). What triggers the individualized threshold is your earnings, not your medical spending: when gross earnings exceed the charted amount, the SSA field office determines whether you would qualify under a higher individualized threshold.1 That calculation starts from Georgia's $24,876 Base Amount and adds each of the following that applies to you.2

• The higher of your own actual Medicaid expenditures or the charted $17,051 average per-capita figure.1
• The applicable Georgia state supplement rate, which is $0 on the 2026 chart.1
• Any Impairment-Related Work Expenses (IRWEs) or Blind Work Expenses (BWEs) you have.2
• Income excluded under an approved Plan to Achieve Self-Support (PASS).2
• The value of publicly funded personal or attendant care you receive.2

Above-average Medicaid spending is one of those five add-ons, not the entrance test. So the individualized calculation is worth running even if your Medicaid use is ordinary, as long as you have work expenses, a PASS, or publicly funded attendant care. If you have none of those expenses at all, SSA finds you ineligible.2

The add-ons tend to be largest for Georgians who use expensive Medicaid services, including:

• Participants in Georgia's home and community-based services (HCBS) waivers, such as the Comprehensive Supports Waiver (COMP) and the New Options Waiver (NOW), which fund intensive community supports for people with intellectual and developmental disabilities.5
• People taking specialty prescription drugs, such as HIV antiretrovirals, cancer therapies, or biologic medications.
• People who use Medicaid-funded personal care or who see specialists frequently.

SSA's field office runs this calculation on its own once your gross earnings pass the charted amount, but it can only count the expenses it knows about. Gather documentation of your Medicaid use over the past year (waiver authorizations and Medicaid claims history from the Georgia Department of Community Health) along with records of any IRWEs, BWEs, PASS-excluded income, or publicly funded attendant care, and get them to your local SSA office at 1-800-772-1213 so the individualized threshold under POMS SI 02302.050 reflects your real costs. Update SSA when those costs change.6

From SSI Cash to 1619(b): How the Switch Works

While you are still on SSI, working does not end your benefits all at once. SSI counts your earnings and shrinks the cash payment as countable income rises, rather than cutting it off the moment you start work. The payment reaches zero when countable income reaches the SSI Federal Benefit Rate, which is $994 a month for an individual in 2026.3

Once your earnings are high enough that no regular (1611) or 1619(a) cash payment is due, 1619(b) takes over: the cash stops, but Medicaid continues.2 The gross-earnings point where the cash payment reaches zero is the same $24,876 Base Amount built into Georgia's threshold.1 From there, Medicaid keeps going until gross earnings pass the full $41,927 threshold.1 SSA tracks earnings month by month and updates your status code; Georgia Medicaid continues without a gap.

Section 1619(b) vs. QDWI

Section 1619(b) is often confused with the Qualified Disabled and Working Individual (QDWI) program, the fourth Medicare Savings Program. They protect different people. Section 1619(b) keeps full Medicaid for former SSI recipients. QDWI helps a former Social Security Disability Insurance (SSDI) worker who lost premium-free Medicare Part A after earnings rose above the Substantial Gainful Activity (SGA) level, which is $1,690 a month for a non-blind worker in 2026.7

In Georgia, QDWI pays the Medicare Part A premium, which is $311 a month for someone with 30 to 39 quarters of work and $565 a month for someone with fewer than 30 quarters in 2026.8 The QDWI income limit is set at 200% of the federal poverty level, and its published 2026 ceiling for the 48 contiguous states and Washington, D.C. is $5,405 a month for an individual and $7,299 a month for a couple.9 QDWI's resource limit is $4,000 for an individual and $6,000 for a couple.4

How Georgia Administers Section 1619(b)

Georgia is an SSI-criteria state: it covers SSI recipients automatically, and its aged, blind, and disabled Medicaid financial limits track the federal SSI standards.3 Because of that link, 1619(b) status flows from SSA to the Georgia Department of Community Health (DCH) electronically, and Medicaid continues without a separate state determination.2 In the eight 209(b) states (Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, and Virginia), a 1619 eligible must have been eligible for Medicaid in the month immediately before 1619 status began in order to keep it. Georgia is not one of those states, so that condition does not apply here.2

In practice, a Georgia 1619(b) beneficiary should:

• Report earnings to SSA each month (online at ssa.gov, by phone at 1-800-772-1213, or in person).10
• Verify Medicaid coverage at gateway.ga.gov or by calling DCH Member Services at 1-866-211-0950.11
• Respond to the annual Medicaid renewal from the Georgia Division of Family and Children Services (DFCS) at 1-877-423-4746.12
• Report changes in income, resources, household, or living arrangement to SSA promptly, since unreported changes can cause overpayments or loss of status.

Work Incentives That Stretch the Threshold

SSA work incentives do not reduce the gross earnings that get compared against the charted $41,927 threshold. What they do is raise your individualized threshold, because each one is an add-on in that calculation, so you can earn more without losing coverage.2 Impairment-Related Work Expenses (IRWEs) are disability-related costs you pay in order to work, such as attendant care or specialized equipment. Blind Work Expenses (BWEs) apply to statutorily blind workers. A Plan to Achieve Self-Support (PASS) lets you set aside income or resources for a specific work goal, and income excluded under an approved PASS is added to your individualized threshold.2

Each of these is administered by SSA. The Georgia Vocational Rehabilitation Agency (GVRA) and SSA's Ticket to Work program can help you document expenses and build a PASS plan, so ask before assuming earnings near the threshold will end your coverage.

Worked Examples for Georgia

The following examples are illustrative. Names and figures are hypothetical, and exact thresholds depend on your own Medicaid costs and earnings.

Example 1: Approval Below the Threshold (Linda, Atlanta)

Linda received SSI for five years and started a part-time grocery job earning $1,800 a month, or $21,600 a year. Because that is well below Georgia's $41,927 threshold, she keeps full Medicaid once her SSI cash stops, and her prescriptions, primary care, and physical therapy continue without a gap.1

Example 2: Individualized Threshold for a Waiver User (Rebecca, Macon)

Rebecca participates in Georgia's COMP waiver, which funds intensive community supports for people with higher support needs, and she takes specialty medications, so her annual Medicaid cost runs well above the $17,051 charted average.5 She starts a job paying $52,800 a year, above the standard $41,927 threshold.1 Because her gross earnings exceed the charted amount, the SSA field office runs an individualized threshold: it starts from the $24,876 Base Amount and adds the higher of her actual Medicaid expenditures or the $17,051 average, plus any other qualifying expenses she has. Her ceiling lands above her earnings, and she keeps Medicaid and her waiver.1

Example 3: Earnings Above the Threshold (Marcus, Augusta)

Marcus earns $54,000 a year as a software developer and uses little Medicaid, only routine visits and generic drugs. His earnings exceed the charted threshold, so SSA runs the individualized calculation. His actual Medicaid cost is below the $17,051 average already built into the standard figure, and he has no work expenses, no PASS, and no publicly funded attendant care, so the calculation adds nothing beyond what the charted $41,927 already gives him.1 His earnings exceed that, so he loses 1619(b) and moves to subsidized coverage through the Health Insurance Marketplace. This is the program working as intended: his earnings have grown past the point where he needs Medicaid.

What Happens When Section 1619(b) Ends

Section 1619(b) ends when you no longer meet one of the five criteria, most often when earnings pass both the charted threshold and any individualized threshold, when resources exceed $2,000 for an individual or $3,000 for a couple, or when your disability finding changes.3,2 You receive notice from SSA and from Georgia DCH. Depending on your situation, the next coverage step is usually one of these.

• The Health Insurance Marketplace. Losing Medicaid opens a special enrollment period at healthcare.gov, where subsidized private plans are available; this is the typical path for someone who lost 1619(b) by earning above the threshold.
• Georgia Pathways to Coverage. Georgia Pathways to Coverage covers working adults ages 19 to 64 with income up to 100% of the federal poverty level who complete at least 80 hours a month of qualifying activities.13 Because it caps at 100% of the poverty level, it generally does not fit someone who lost 1619(b) by earning a higher wage.
• Medicare Savings Programs or QDWI. If you become entitled to Medicare, a Medicare Savings Program can pay premiums and cost-sharing. In Georgia for 2026, the Qualified Medicare Beneficiary program (QMB) covers up to $1,350 a month for an individual, the Specified Low-Income Medicare Beneficiary program (SLMB) up to $1,616, and the Qualifying Individual program (QI) up to $1,816, each with a resource limit of $9,950 for an individual and $14,910 for a couple.9 Those are the federal standards rather than absolute cutoffs, since states can disregard additional income and resources, so apply rather than rule yourself out.8

Common Mistakes With Georgia Section 1619(b)

• Assuming work ends Medicaid. Section 1619(b) exists precisely so that earnings up to $41,927 a year in 2026 do not cost a former SSI recipient their Medicaid.1
• Treating $41,927 as the hard cutoff. Passing the charted amount does not by itself end coverage. SSA's field office then checks you against a higher individualized threshold, and it can only count the expenses it knows about, so make sure SSA has your Medicaid-cost, work-expense, PASS, and attendant-care records.1
• Confusing 1619(b) with QDWI. Section 1619(b) gives full Medicaid to former SSI recipients; QDWI pays only the Medicare Part A premium for former SSDI workers.4
• Letting resources exceed the limit. The SSI resource limit of $2,000 for an individual or $3,000 for a couple still applies, and an inheritance, settlement, or accumulated savings can break eligibility.3
• Not reporting earnings to SSA. Monthly wage reporting is required; missed reports cause overpayments and can end 1619(b) status.2
• Assuming a separate Medicaid application is needed. In Georgia, 1619(b) Medicaid continues automatically once SSA sets the status.2
• Assuming 1619(b) covers Medicare costs. Section 1619(b) protects Medicaid, not Medicare. If you also have Medicare, a Medicare Savings Program is what helps with those premiums and cost-sharing.4

How to Keep Medicaid While Working

Who to Call for Help With Section 1619(b) in Georgia

If you receive SSI and want to return to work without losing Medicaid, these free resources can help.

Find personalized help keeping Medicaid while working in Georgia at brevy.com.

Learn More

Find personalized help keeping Medicaid while working in Georgia at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.