Derek >> Thank you, Jayme. Good afternoon and welcome, everyone, to today’s Ticket to Work webinar: Healthcare and the Path to Employment. As Jayme said, my name is Derek Shields and I am a member of the Ticket to Work Program and I will serve as your moderator today. Thank you for joining us to learn about Social Security’s Ticket to Work Program, Work Incentives, the impact that choosing to work may have on your Medicaid and Medicare benefits, and importantly, also about your employment team. Today’s topics can help you as you start or choose to expand your path to financial independence through work. Each of us is on our own journey and we hope you can get some information today that will help you on your path to employment. Let’s get started by reviewing some of the functions of this webinar platform so you can interact to get the most out of today’s presentation. First, you can manage your audio using the audio option at the top of your screen. The audio option is an icon that looks like a microphone or telephone. All attendees will be muted throughout today’s webinar. Thus when presented with options for joining the audio conference, choose listen-only, in the bottom right. Choosing listen-only allows you to have the sound to be casted through your computer speakers or, if you prefer, headphones. So please make sure that your speakers are turned on or your headphones are plugged in. If you do not have sound capabilities on your computer or prefer to listen by telephone, please dial 1-800-832-0736 and then you can enter the access code 418-9148 pound sign. All right. Now let’s move to cover some information about our webinar accessibility. On the Adobe Connect platform, you will notice different boxes on your screen. These boxes are called pods. We have the presentation pod and this is where the slide deck appears. That is the largest portion of your screen. Below that is an open space really for the placement of the closed captioning pod. The top right corner is the Q&A pod. Below that is the web links pod. We are going to talk about these pods in more detail in just a little bit. If you do need assistance navigating Adobe Connect, an Accessibility User Guide complete with a list of controls is available on the website at https://choosework.ssa.gov. The link is also available in the web links pod in the bottom right of your screen. It will be entitled Adobe Accessibility User Guide. That is the fourth option down. Real-time captioning is available and active and is displayed in the captioning pod. It can be placed below the slides. You are able to show or hide the captioning display and you can also choose the text size and text color accommodations to best meet your vision preferences. Open the closed captioning pod by selecting the CC option from the top menu bar. The captioning link can also be accessed in the web links pod under the title Web Captioning. If you are fluent in American Sign Language and would like support during today’s webinar, please follow the link below that provides instructions on how to connect with an interpreter through the Federal Communications Commission Video Relay Service. The ASL User Guide is available in the web links pod under the title ASL User Guide. That is option 6 in the web links pod. We are here today to answer questions that you may have about the Ticket to Work Program. Please send your questions to us at any time during the webinar by typing them into the Q&A pod. We will be addressing these questions at two different points during the presentation and our speaker will be able to answer questions. So please send us those questions and we will do our best to get to as many as possible. If you are listening by phone and are not logged into the webinar platform, you may ask your questions by sending us an email to Ticket to Work. That email address is webinars@choosework.SSA.gov. Another resource that we think you’ll find very useful is this web links pod that I have been mentioning. Web links pod is in the bottom right of your screen. At least the links for the resources covered in today’s webinar. To access these resources, specific topics of interest to you, you can select them and use the bar to navigate the web links with. If you are listening by phone and are notable to access the webinar platform, you may email webinars@choosework.SSA.gov. for a list of these available resources, you may also reference your confirmation email for today’s webinar to access the available resources. Also please note that Social Security cannot guarantee and is not responsible for the accessibility of external websites. Today’s webinar is being recorded and a copy of it will be available within two weeks on the choose work website at https://protect-us.mimecast.com/s/8vuHCOY2RlF25kVYTjHyx4  This link as well as others that pick up can be found in the web links in the bottom right-hand corner of your screen it will be titled WISE Webinar Archives. We hope everyone has a great experience during this webinar. However if you experience any technical difficulties, please use the Q&A pod to send us a message. Or you can email us at webinars@choosework.SSA.gov. Our team will help you. As I mentioned, my name is Derek Shields but I am a member of the Ticket to Work team and I will be serving as your moderator. We also are delighted to have with us Ray Cebula, our presenter. He received his law degree from the University of New Hampshire’s Franklin Pierce school of Law. He spent 22 years providing legal services to individuals with disabilities and their interactions with Social Security. Ray then became a part of Cornell University’s Work Incentives support center. In 2005, he joined the staff of Cornell’s Institute on Employment and Disability. He now serves as the program director of YTI online, Cornell’s Work Incentives credentialing program. During today’s webinar, Ray will cover the Ticket to Work Program, Work Incentives, the impact that choosing work may have on your Medicaid and Medicare benefits, and importantly also benefits counseling and service providers. It is not my pleasure to welcome rate for him to begin with an overview of the Social Security benefits program and an introduction to the Ticket Program. Perhaps we will have a start by covering your specific objectives first. Over to you, Ray. 
Ray >> Thank you, Derek. And welcome everybody. Today’s topics, Medicare and Medicaid and what will happen to your health benefits when we return to work, is critically not in my history with working with recipients who are returning to work I very often hear that it is not a benefits that people receive that they are concerned about. It is the healthcare that comes along with that. And hopefully today is going to convince you that your healthcare will continue for a good longtime and no one is going to take that away from you until you are in the private market with the rest of us and your needs are met. So as our objectives today, we are going to start with a basic overview of Social Security disability benefits. We will go over what programs are involved and what healthcare benefits come with those. We are going to understand how that program can help the Ticket to Work Program if you choose. We always have the straight talking and the urban myths that talk very loudly. And a lot of them are just that. They are myths. So we are going to take those myths And build some real facts. And finally we will provide access additional resources related to the Ticket Program, Medicare, and Medicaid. I want to echo Derek’s comment about the web link pod. A lot of what we will be talking about will be found in the pod and I wanted to, I am hoping that I will refer you to that at the right times. There is good information in there. The Ticket Program, you know, the Ticket to Work Program and supporting your path to work is what this is all about. All of our sessions talk about it because we want you to have the support that you need to work and become independent of your benefits. And potentially it is your healthcare. As I said, healthcare is going to be around for a long time. So let’s start out with those two disability programs. We have a Social Security Disability also called SSI, and please note that that is a Social Security Disability Insurance Program which is a program that people have paid into while working. If you have worked and have FICA taxes withheld from your paycheck, that is what is being used to fund disability insurance benefits. Your amount of benefits is going to depend on how long you worked and how much you earned. There is a maximum. And everybody’s benefit is going to be different because of that. You need to have a fairly long history, sometimes up to 10 years to become insured. Again, it is insurance. So we do not care about your resources, we do not care about any unearned income that you may have.
Now we need to contrast that with Supplemental Security Income, SSI, notice does not say it doesn’t say insurance. This is an needs based and to provide by Social Security to people have not worked enough to be insured for SSDI or do not have a work history at all. So it is very, very different. It is also going to look to see if you have very low resource amounts and income amounts so that we have categorical, financial, and resources that we are going to be talking about in the SSI program. Now directly related to today’s session, SSDI comes with Medicare. If somebody is eligible for Medicaid in their state, you need to apply for that separately through your state Medicaid agency. Now SSI automatically is paid to recipients of SSI. Medicaid comes with this program. Different program, the Medicaid program also has resource limitations and income limitations. Now in 46 states, um, that happens automatically. But in four states, you need to apply separately for Medicaid. Now once you are in, you have a good long time to work yourself off of these benefits. It is a very long time. And we are going to talk about that in a bit. I just wanted to get you through the two programs, SSDI coming with Medicare, SSI coming with Medicaid. Now how do you find out which benefit you may be on? You can look to a my Social Security account. These accounts have to be set up on the Social Security website and they will ask you for some personal information and you can be sure it is safe with Social Security and what will also happen is it will give you information about your work history. Mine shows my work history from your 16th birthday and it goes back a very long time. It will tell you if you are eligible for SSDI how much you will receive and it will tell you how much your family members will receive if you have dependents. On the SSI side, it will clarify that your benefits are SSI and how much those benefits are. All of that information is good information to help you on your journey to work because it is going to be the benefits planner information, some basic information that they can use to explain how work affects everything. Sign up for one. Sign up for one. I’m on several times a year and I am about to do it again and will have a new numbers for 2023 available. There’s a lot of great information that will provide you again with information your planner will need it. Starting this journey, I think we have this slide every month and it is a very important one. Only you can decide if work is the right choice for you. We are going to give you information. We are going to tell you what may occur should you go to work and you will hopefully make an informed decision as to whether or not work is right for you and whether or not now is the time to begin work. We are here to help guide that process by giving you all of the information, all of the projections that we could potentially come up with. So that you will know what will happen before it happens. Why choose work? Work works. It really does, it gets people out of poverty and it gets people the ability to make a choice. You have more choice if you are working and earning more than your benefits are. You may have some excess. Work is great. But we also look forward to that pizza and a beer on Friday you know? And the work, just the act of working and collecting a paycheck can make that happen. Earning a living through employment is not something everybody can do. We know that. The Social Security disability standard is very tough, but it might be the right choice for you. And once you understand the free services and supports that the Ticket to Work will bring to bear to support you, you know, many people often decide that the rewards of this and the work will far outweigh the risks. And, again, today’s session is going to focus on healthcare and there’s very little risk when healthcare continues as long as you see that it will. The Ticket to Work Program is part of the Ticket to Work Act and it is free and voluntary. Notice voluntary is a bolded. You do not have to participate. You do not need that ticket to make use of the Work Incentives that Social Security has. But when you use the ticket, you get a lot of extra services that you would otherwise pay for. And these services involve career development, looking at people ages 18 to 64 who receive a disability benefit from Social Security and who want to work. That is the only requirement. You want to work. It is also time to start using services to explore that potential. The Ticket to Work connects you with free implement services to have you decide if work is right. We need to give you that information as I said earlier. You can make an informed decision. You will know what exists, what will occur to your benefits as you begin working, and most importantly for today, what will happen to that healthcare? How about preparing for work? You know, somebody might need some educational prep, somebody might have to have rehabilitative preparation. We can do that. Help you find a job, the Employment Networks that we’ll talk about in a few minutes, they are experts at that. They know their territory, they know where the jobs are, they can help you prepare that resume, help you with some interview practice and point, less go over to this employer. It seems like a good match, send your resume over there. How about succeeding at work? This is a very important part I think it is the most important part of all of the services because when you get that job and you start working, we want you to succeed so you are not on your own just because you found a job and start working. That Employment Network can provide services be they on-the-job, be they support outside of the job, whatever will help you succeed, the Ticket to Work can bring all of those services to bear. And I think that is a great thing, you know, I think that is a really wonderful thing. How about Work Incentives in the Ticket Program? We have Social Security, as I said, you’re going to get these Work Incentives, whether you participate with the ticket or not. But again, layering that to get on top of all of these Work Incentives, it is a great thing. Social Security makes a total of more than 20 Work Incentives available. Some of them apply to SSDI. Some of them apply to SSI. Some of them sound real similar and are used in both but for very different reasons. But Work Incentives make it possible for you to work while still receiving benefits. The details about that are to be discussed with you when we know what type of benefit you receive. But I can tell you that a good planner is going to make sure you have more money at the end of the month than you have now. That is the goal in what planners want to happen for you. They are designed to help you succeed. Just the act of working and receiving your benefits at the same time shows how much we all want you to succeed. How many and what kind of Work Incentives are going to depend on the type of benefit you receive. If you’re not sure right now, you might get a notice from Social Security and it would tell you. You might want to set up that my Social Security account when we finish today. Clearly we’re going to keep your Medicare and Medicaid for a good long time I told you that and I’ve been teasing you and we will tell you about that. You will have access to individualized services and supports. This isn’t cookie counter stuff. You are an individual. You will have your own challenges to returning to work and we need to customize services to fit your situation. And keeping all benefits payments as you transition, or some of them, in some cases, in SSI case, you benefit may drop. But remember that as a benefit drops, your income is going up more than the total benefits you ever had. The math doesn’t work any other way. Once you work on SSI, you will have your money. The Redbook, now Social Security does have the Redbook available online in English and in Spanish. It’s a good reference guide and it would tell you a little bit about each one of the Work Incentives that is involved. And it has some other information. It includes resources for people, finding or returning to work, information about all the of the Work Incentives and additional information about healthcare and Medicare Medicaid for people with disabilities and resources to help transition age youth in their efforts to navigating toward that work goal when they become adults. Those kids, as I refer to them, are very, very important. We can take a kid who is in high school and give them some work experience. We can make that kid a worker with a disability rather than a recipient with a disability. Someone who starts their work life out as an independent person. Now that Redbook is being updated very soon since we know what the numbers are for 2023, editing has begun. Watch the website and likely Social Security will send out a public service notice when it is ready as well. Now the Ticket to Work Help Line might be a great way to start your exploration. Again, there is no wrong door here. But if you are looking for someone to talk to about what might happen if you go to work and who in your area might be able to talk to you about that, call that Helpline. They are open Monday to Friday from 8:00am to 8:00pm Eastern time and the number is 866-968-7842 or for TTY users, 866-833-2967. Ok, Derek, we are at our first Q&A session. 
Derek >> Thanks, Ray, I appreciate overview of our objectives today. And then getting into the Ticket to Work Program. We do have some questions that have come in. We would like for you to either repeat it or dig in a little deeper if you could. A question has been asked a couple of times and basically is there any fee or cost for me to participate in the Ticket to Work Program. 
Ray >> No. There is not anything at all. You know, there is no cost to you. Yet if you do have some resources that you might want to bring to bear, we might be able to get you into programs such as the Plan to Achieve Self Support but generally, no, there is no financial obligation on your part. We just want the willing to work. 
Derek >> Thanks, Ray. This is Derek again. If someone wants to get started on the Ticket Program, do they have to have work experience in the past? 
Ray >> No. Not necessarily. As I said, on the SSI side of things, people can receive those benefits based on disability and have never worked at all but might want to work to improve their financial well-being. And we just need to sit down and chat. As I said during that one slide, the Ticket to Work and help you talk about what you might want to be interested in doing for work. Yet we can test --the good thing about the Ticket to Work and those Work Incentives as they can try different jobs until we find the one that is the right fit for you. So no, you do not need work experience to start this. We can get that for you.
Derek >> Thanks, Ray. When you say you can try different jobs, we had a question of somebody said we want to try, like, a new path, meaning I want to learn something different, new, or that have not done before, so you are saying that this is a good program for them to be able to try out something new?
Ray >> Yes. Absolutely. I mean, everybody who has received one of those two benefits has a disability. If that disability was incurred, you know, through work, you know, while you were working, it may very well, you may have to learn to do that job again yet you may decide as you are questioning the case that I want to try something different. And the education that you might need, the training that you might need, vocational or otherwise, it will all be available to you.
Derek >> Nice, thanks for that.  I think it really helped some folks decide that this is right and I can explore things and if I try it and it doesn’t work, then I can alter my approach, too. Ray, who is eligible, a lot of folks, you cover that, but sometimes I don’t think it is easily captured, well, my part of that age group or if I am receiving of the right benefit, who is eligible for the Ticket Program?
Ray >> The Ticket to Work does have eligibility criteria and I said aged 18 to 64, the trick about being 18 is that you just become adult in Social Security’s eyes and you have been found disabled as an adult so kids who receive SSI generally receive the benefits because they are not developing as a normal kid in the third grade would. You know, and we can find that you are not disabled because of that. When you turn 18, the question becomes can you work, and where work was not considered when you were a child, it will be considered at age 18. It is called an age 18 redetermination. It happens to every child who turns a teen on the SSI program. Nothing to fear. We just have to prove that you are a disabled adult so that you can participate in the program. And on the other end, this stops at age 65. Between those two ages, you are good to go. Remember that second criteria, though, you have got to want to work. You just need to have that desire.
Derek >> This is Derek again.  Thanks, Ray.  We really appreciate that. We have covered a couple of questions here and I think a lot more questions will come in around Healthcare and the Path to Employment theme that we want to get into so back to you, Ray. Let’s continue.
Ray >> Thank you. Here we have the big stuff. Medicare or Medicaid coverage and the path to work, we know this is going to be important. And as I said earlier, many times I have heard that it is most important when someone is returning to work. So let’s get into it. We’ve got some of those myths right here. True or false, if I go to work, I will automatically lose my Medicare or Medicaid. My guess is the street is telling you one thing but they are not telling you the right thing. The answer is false. If you are receiving a benefit payment and any amounts, you will keep your Medicare. If your benefit payments stop due to earnings from work and you remain medically disabled, you may be able to keep that Medicare or Medicaid through Work Incentives or through a buy-in programs, many states, up to 43 states have Medicaid buy-in programs. Everybody has a Medicare buy-in safety net. And we will talk about those too. So Medicaid and Work Incentives, what you have to remember from the earlier discussion we had, Medicaid is provided to SSI recipients. That is a program we must associate with SSI. Medicaid is administered by a state agency and it could be department of social services, your department of public welfare or it could be a separate one. So let’s talk about the Work Incentives that have been specific to Medicaid health benefits. Medicaid while working, a program known as 1619b, if you use that term, 1619b, everybody will understand what you’re talking about and the Medicaid buy-in program, both of these things are sincerely the best thing since sliced bread. To be able to continue to get healthcare while you are working and then sleep into the buy-in program because your work has been incredibly successful, making sure you can keep some of the services that are directly supporting your work effort, so remember again you have to be receiving SSI. You can qualify for Medicaid coverage when you are benefits payments stop. If you have been eligible for an SSI payment for at least one month, so if you are an SSI beneficiary, that is probably what happened you got a cash payment at some point. You continue to meet the definition of disability. When you are working, you do not really have to worry about Social Security purposely looking at you and saying we are going to have to look at his disability status again. It’s not going to happen, it will happen in due time as it happens to everyone. I know people who have gone for years and years and years and continue to meet the definition of disability and work at the same time. You have to meet the other non-disability requirements of SSI. Remember I said they are going to look at your resources. They are not going to consider your income from work because that is the key to getting into this program, 1619b, but they might look at income you are receiving from someplace else. You need Medicaid benefits to work. Of course you need healthcare to work. The Ticket to Work Act was the first time Congress ever said people need health insurance if they are going to work. And 1619b will provide that very thing. And you have to have gross earnings before taxes that are below your state threshold. We will talk about that too. Every state has a threshold. They differ pretty dramatically. And you will understand why that is the case when we get to the definition of what a threshold is. If you are interested, when you get off todays webinar, Google the name of your state and SSI threshold and it will be one of the first hits you are going to get. That threshold is the measure that Social Security uses to decide when your income becomes high enough to replace your SSI and Medicaid benefits. And how they figure that is the amount of earnings that would cause SSI payments to stop in your state, some states supplement these benefits, so it is a little bit different, and the average annual per capita Medicaid expenditure for your state. So if I’m about to go to work, I would have to report how much money I am earning and Social Security will determine if I am eligible for a payment at all. The next step is they need to contact, Social Security is in contact with the Medicaid agency so that they can provide information about how much the average SSI recipient on Medicaid living in the community spends each year, how much did the state spend on Medicaid, you know, and again, here is a link. It is in your pod as well to see the threshold amounts. They should be changing fairly soon. We hope by January or February that we will have that information as to how much these thresholds have gone up or gone down. My guess is because it is the pandemic period that is left, we will see a lot of them go up. But be careful. You’ve got to look at your particular state. Now if your gross earnings Ð you know, let me go back a slide and tell you what this is all about. Now when you are receiving 1619b Medicaid remember that you are earning enough to get zero in SSI benefits. You are still an SSI recipient eligible for zero and that is why Medicaid continues. And so we are working above that zero mark and this can continue in some states to $28,000 a year and some states it is over $50,000 a year. It depends on where you are. As we work our way up and surpass your state’s threshold, you can request an individual threshold. And that is going to help make your threshold higher based upon your work expenses, based upon, how about the PASS plan when we mentioned earlier, publicly funded attended a personal care, anytime your medical expenses are more than the average, we can increase your threshold so that you will continue to get Medicaid as you work. Remember that this has to be requested so anytime I see attendant care, private duty nursing care, personal care attendants, where a lot of durable medical equipment, this is something to consider because those are very expensive services. And again, your benefits planner, your Employment Network should be able to help you out and help make that request. Now what happens if you are working and you are earning above the 1619b threshold? Like I said, in 43 states, there is Medicaid buy-in program. And again, Medicaid is run by the state, so this is pretty fantastic also. Let’s say we are in a $50,000 state, so I’m earning $51,000 now. If I would to Medicaid because, you know, maybe I have been insurance to my employer, but Medicaid is paying for some of those critical services that private insurance will not pay, I can buy into the system. When you look at the national cost average of doing that, this is cheap. This is really cheap. Some states have a base payment. Some states tie it to the amount of income you are receiving. But had the how do you qualify for this? You have to meet that definition of disability. And you would be eligible for SSI payments if we did not look at your earnings, pretty simple. Pretty simple. So what they would do to me is take away $51,000 a year, would I be eligible for SSI and the answer is yes, if you don’t have any income, I am qualified for this. This is a fabulous program. I am from Massachusetts. This program started with a Massachusetts Waiver Program.  And we were all kind of amazed to see it go nationwide under the Ticket to Work Act. It is incredible. That basically means that you have a much higher threshold than 1619b to continue to keep some very important healthcare services. That is a good deal People for SSDI, remember I said SSI comes as Medicaid, the people who are on SSDI often qualify for Medicaid and it depends on your income as well as your resources that are going look at. Do not underestimate the value of buy-in programs in the 43 states Medicaid while working, 1619b, there is a continued Medicaid eligibility link in your web link pod. And for the buy-in, state Medicaid agencies know what your threshold is, know for the state. Check that out. You find you can learn a whole lot more than you ever expected. Now Medicare, let’s change the page, will put on the Medicare had rather than the Medicaid at and start talking about SSDI and healthcare, so the Medicaid program, so the Work Incentives, we have an extended period of Medicare coverage and we have Medicare for people with disabilities they work a little bit differently. That extended period of Medicare coverage, most SSDI beneficiaries who benefits stop because of earnings will continue to receive at least 93 months of hospital insurance, Part A, supplemental medical insurance, basic healthcare, Part B, and prescription drug care, Part D, if you enroll in those. For at least a three months, that is over 7 years, that is a great thing yet this is after you finish your nine month Trial Work Period. So you can begin working, use your Trial WorkPeriod, then you still have over 7 years worth of Medicare. That is a long time. A safety net to allow you to focus on work rather than worry about your healthcare. You are entitled to be a recipient with Medicare benefits and you are working at substantial gainful activity levels. If you are working a penny above those levels, remember that you lose your benefit for Title 2. That is in the name of the game here. And you must also remain disabled. And you will still be protected for 93 months worth of benefits. That is not the end of it. That is not the end of it at all. Medicare people with disabilities who work, after premium free Medicare coverage ends because of work, you can continue to buy the coverage if you remain medically disabled. At this point in time, you have worked a real long while. You are eligible to buy Medicare coverage if you are not yet 65, because at 65, you become eligible for Medicare based on age. You continue to have a disabling impairment and your Medicare stopped due to earnings from work. So these healthcare benefits are going on for years. For more information on Medicare enrollment periods or to make an appointment to enroll, you should be calling Social Security at 1-800-772-1213 or 1-800-325-0778 for TTY users. For help paying with premiums, you know the Medicare premiums are not unreasonable by any stretch of the imagination but you may need some help and we have Medicare savings plans run by the states in the Medicaid program that might be able to help with some assistance to pay for all or part of your premiums. You got to have a Medicare number. That means you have a card, that’s all, I’ve got my part A card and has been case number on it. And be prepared to tell the representative what state you live in and to get that information, you’ve got to call Medicare at 1-800-Medicare or, for TTY users, 1-877-486-2048.All right, Derek. That was a mouthful. We are at the next question session.
Derek >> This is Derek. Thank you, Ray. That was a little bit more technical and we got into some important details these are, we also questions about, and there are some of the most frequently asked questions, so I’m going to do again, we will see if we can get through a bunch of them here. Several people have been asking about the nine months. And you talked about trial working, and I just want to check in to talk about that a little bit more. When you say Trial Work Period and nine months is that nine months in a row? Can you have these long pauses? Can you explain that a little more for us?
Ray >> The trial work period is a nine-month period. It does not have to be consecutive months. But those months must happen within a five-year period. So you will use a trial month if you’re using your earnings for the month exceed $940. This year, that will go up in January. But so any month where I go to work, I earn $1000, it will be a trial work month. I do not have to use them consecutively. Although I believe it is the best way to test your ability to work for a long period of time, but if I am working, let’s say I go to Mr. Walmart again and I start working there and my job is guaranteed for the holiday season so I am going to work in November at $1000, December $1000, in January at $1000, if after that my income drops to $500 because that’s all Walmart needs me for after the holiday season, I’m only going to be at $500 so I will not have used trial work months. And then maybe the next holiday season, Iam back up to $1000 and I would use three more months. That is how you would also use it. Again, those months have to fall within 5 years. And the question is how do you best use the Trial Work Period to test your ability to work. And I do not think it is working 3 months a year. That may be a test to show what your capacity for work is pick if you cannot continue working at $1000, then by all means, let’s reduce that. But I think that the Trial Work Period should be used as close together as possible as you can so that you can test not only your capacity but your ability to continue that capacity over time.
Derek >> This is Derek.  Thanks, Ray.  We have another one here. And this gets to keeping SSDI and the question is basically you are saying that if I work and keep my SSDI, I also keep my Medicare. Is that true?
Ray >> You will also keep your Medicare during the Trial Work Period. You will not lose anything. You will get your full SSDI benefit and your full Medicare. After the Trial Work Period, it will depend on how much you are earning. If you are below that Substantial Gainful Activity level, you will keep your benefits and you will then keep your Medicare. Anytime you get a benefit from Social Security, you keep Medicare. If you, you are not going to get a cash benefit but you will be able to still keep your Medicare.
Derek >> Thank you. Here is a follow-on going towards SSI now. I have SSI.I heard you say I could keep Medicaid coverage when my payment stops due to work earnings but only in some states. Where can I find that information?
Ray >> You are going to be able to keep your earnings in all states if you are still in the 1619b program. In some states is what I used when we were talking about the Medicaid buy-in, you know, because there were seven states that do not have buy-ins. And so that is exceeding the 1619b threshold. If you Google 1619b states, you are likely to get a hit pretty high up that’s going to give you a chart of which states do and which states do not.
Derek >> This is Derek.  Thanks again Ray. Just going back to the last question, I think we have a Trial Work Period amount of $970 and I just wanted to be clear on that as opposed to –
Ray >> Yes, you know, I am, that is probably me talking in a rush. I do believe you are correct. Yes. You are correct. In 2022, it is $970. I apologize.
Derek >> Okay. No problem. We appreciate it. We are going through a lot of content and I just wanted to bring that up. Next question, if my earnings are higher than threshold amount, are there any other ways I can qualify?
Ray >> Remember that individualized threshold. That individualized threshold, again, I will use my on examples from my experience, if you have personal care attendants, if you have private nursing, if you have a lot of durable medical equipment, because those services are so expensive you might exceed what your state average Medicaid expense would be and that would be one way to keep it. Again, the other way is to slip into your states buy-in if that exists. You know, in those 43 states where it does exist, it is a great thing because it does allow you, for reason were pretty, very reasonable premium, to keep your healthcare going. That becomes important because if you are looking at personal care attendants, if you are looking at a lot of durable medical equipment, it might be tough to get that from an employment related health insurance policy.
Derek >> Thanks, Ray.  This is Derek again. What happens if I take my employer’s insurance and stop working, so if I stop Medicare either Part B and/or part D can I get it back if work doesn’t really work out for me in the long run?
Ray >> That is an exceptional question that is a really good question. Yes. There is a possibility that you can. You know, when I turn 65, I was pretty much asked by my insurance plan to register because there is no cost to me for Part A. If you have no insurance in that age 65 comes around, there is going to be, you know, a Medicare Part A, B, C, and D that you get to pick and choose from. And if you have what is called creditable coverage, meaning that you have a private employer plan is as good as Medicare A better, you can leave Medicare behind. And then if your policy ends because employment does not work out for you, then you reopen that Medicare account, but remember creditable coverage and the quickest way to find out if your insurance is creditable with Social Security and Medicare purposes, is to call that insurance plan. I get a letter from Blue Cross every year that says your insurance is creditable for Social Security and Medicare purposes. If you do not get a letter like that from your plan, calling them is the best way because they should be able to tell you what off the top of your head that yes it is or no it isn’t and request a letter verifying that that is and then you are good to go.
Derek >> Thanks, Ray.  This is Derek.  I appreciate this notion on checking on creditable Coverage. I have heard from you today, you mentioned that this 93 month period where you’re going to be okay, and you can have access to coverage, I just heard you say that you can come back if you have creditable coverage, you can return to Medicare coverage. So there’s a lot of flexibilities here that coverage will go a long way but really I’m getting to this question that we have received a lot of about people being nervous about losing healthcare at a lot of this information we have shared, it still can be complicated. Who can folks go to, to talk about this, especially some of these questions that we get that are coming in. We can’t answer them here because they are really personalized. We can folks go to chat about it?
Ray >> The easiest way to talk to somebody about it is to contact somebody who does benefits planning work. Those benefits planners, we talk to you about what happens to your benefits as you begin to work. Medicare and Medicaid --[ silence ] Are able to walk you through and chart it out on paper for you, everything I have said today. I know it is tough. This is really complicated and it is horribly scary. You know, losing health insurance is scary for everybody who is working in this country. But, as Derek said, it is a bit flexible if you have the right insurance before you check out of the Medicare program. But I definitely would get in touch with benefits planners and we will talk about that and how you can find them once we finish with this question session.
Derek >> This is Derek.  Ray, I think it’s time.  Let’s have You move forward and dig into benefits counseling.
Ray >> Benefits counseling is a critical piece of the return to work puzzle. You look at the benefits here and Medicare and Medicaid, Social Security Disability Insurance, Supplemental Security Income, housing assistance, what about TANF. Family assistance, temporary assistance to needy families; SNAP some food stamp benefits, all of these benefits can be affected by going to work and earning money. Benefits planners will know, they are very well trained, very well supported. They will know what is going to happen to Medicare and Medicaid if you go back to work and earn $1000 a month. They will know what is going to happen to your disability insurance if you earn $1000 or if you are in $1500. Will going back to work me to because the housing authority to raise your rent? I can tell you right now, no, but you need to know the whole picture and that is what benefits planners can do and the food stamp area, many of them have calculators that they can use to give you a good estimate as to what will that thousand dollars of earnings due to your SNAP benefits. And at the same time, if some of these other benefits are getting lower or your rent is increasing, let’s work that into the equation so that you still have more money at the end of the month. There’s enough to make up for what you might lose. And they do it all the time. They are up to date on changes. They know Medicare and Medicaid backwards and forwards. They know the Social Security benefits. They are familiar with the states planning services. They are knowledgeable about housing, SNAP, and all the other benefits that you may be receiving. So it’s kind of like no stone is left unturned when you are talking to a benefits planner. Now these people also provide free services. And I can tell you because I support benefits planners that this is a time-consuming job that is critically important because if you go to work without benefits planning, things are going to happen to you. If you go to work with benefits planning, you will know when those things will happen. And it is a much more powerful position for you to be in to be prepared rather than to have to react. So let’s talk about these providers, three types of providers involved with the Ticket to Work that can provide benefits planning. The WIPA agencies, work incentive planning and assistance projects, there’s one in every state. You know, there is a somebody there who will serve every state in the country. State Vocational Rehabilitation Agencies, your state VR, many of those counselors or benefits planners housed within that agency will be available to help you. And the Employment Networks, remember those people I told you who could provide you with job prep and on-the-job support? Many of those now have benefits planners are trained to help you. And these are the buttons. The WIPA button.  The VR button. The EN button. You will use these when we get to the website. So what is WIPA program tasked with doing? They provide free benefits counseling to eligible Social Security disability beneficiaries about how work is going to affect SSDI, SSI, Medicare, Medicaid, and all of the other benefits you might receive. Help you understand the Work Incentives. Remember we said there are lots of them. There are over 20 of these Work Incentives that might be available to you. And how they work and how they apply to your situation is going to be very important. And what that is going to do is just provide more protection for you. Explain potential benefits of employment and dispel those myths. We know that this can be a nerve-racking decision. We know you could be scared about taking the step. But we want you to have the facts. And having the facts will very well hope that fear and nervousness go away or at least get a whole lot better. It will help you decide if services and support from the Ticket to Work Program are right for you. You can get free benefits planning services and not use your ticket. But as I said, that brings an entire umbrella of services to you. And if those services are something that you would benefit from, the benefits planner can talk to you about those. So who do they serve? Right now, they serve people who are currently working or currently self-employed, people who have a job offer pending, you’ve been offered a job in your waiting to start, people who are actively interviewing for jobs, which means you have had an interview in the past 30 days or you have a job interview scheduled in the next two weeks. And then there’s a special category for those transition age kids, aged 14-25, even if they are just in very early stages of considering going to work, they can be helped by the WIPA programs and I just want to let you know that if you do not fit into those definitions, there are other planners available out there who do not have these requirements. The State Vocational Rehabilitation Agency, you know, they can have benefits planners on the staff. Many of them do. Your New Mexico, they do, back in Massachusetts, they do, in California, they do, so there are a lot of them who can provide you within-house planning services and maybe one-stop shopping is something for you. A state agency provides a really wide variety of services to help people with disabilities return to work. Enter new lines of work, so the person who asked questions about what if I want to do something different now, that is possible. Or you can enter the workforce for the first time. VR can offer benefits planning, if they cannot, there is nothing wrong with saying let’s slow down and let me go to the local WIPA program or the local benefits planner to get some of that information. It is not excluding for benefits planning. They are going to give you a lot of help with vocational rehabilitation. Remember that I mentioned a person who might have to learn to do the job differently because of the disability? That is vocational rehabilitation. How about training and education? What if I want to try something different and I need an Associates degree to do that? I need to go through an vocational school to do what I want to do and that is the state VR agency and what it is all about. Remember that some states have two VR agencies, one for people with disabilities and one for people who are blind or visually impaired and that does not mean that you can’t call the first number you reach in your state. You just may have to be referred to the agency that can serve you best. Employment Networks, you know, we have Employment Networks that serve every part of the country and some of them limit themselves to geographic area or ZIP Code and some of them serve an entire state and some of them can serve the entire country so that is your choice too. Do you want somebody, if you are living in New Mexico, do you want somebody in Boston who is providing your services or would you rather have somebody close that you could meet with personally? That is up to you. I know things can be done by distance I do them by a distance all the time but it is your choice and the Employment Network is a private or public agency that has an agreement with Social Security to provide free employment services that is for people who are eligible for the tickets. Remember that you have to have the Ticket to Work to get services from an EN and everybody between ages 18, if you are disabled adult and age 64 or I should say through age 64 has the tickets. You do not need to pay for tickets, just call the helpline we talked about and they will you know if you have a ticket and who that he ends are that might serve your area. Ok, the ENs and state agencies can provide additional services, this is pretty fantastic too. How about career planning or counseling? A good thing for somebody once you try something different, you know, let’s talk about career planning, what this job might turn into, and how about some counseling to see what might be the best fit for you. Job search, job placement assistance, you know, the VR agency does that, the ENs can do that as well. The state agencies, the VR agencies might have their own training programs in-house. How about special programs for veterans and youth in transition? Those are two very different populations with very different needs. And both of those populations can be served. Ongoing employment support is critical. And what happens is that if you use your ticket, you do not have to assign it, but if you use the VR agency, you can take it to an EN after your VR case is closed so that you can receive ongoing supports, on-the-job supports, and for a lot of people, that is going to be critical. And how about assistance with accommodations? You may determine in your discussions with the state agency or an EN that a reasonable accommodation is going to have to be requested. So how do you do that? How do you have that conversation with your boss? The ENs and VR people are experts in what is reasonable for reasonable accommodation and how to make sure you get it. So how about all of these service providers and getting some more information? I’ve done it really quickly. But to better understand the types of service providers and what they offer, visit the Ticket to Work Meet Your Employment Team and that is exactly what we are, part of your employment team. There is a link in the web pod and the web link pod, WIPA programs, you can find them all, State VR, find them all, ENs, you can find them all, and then Workforce ENs. If any of you are familiar with American Job Centers, their Employment Networks as well are a great place to start pick if you want to visit a job center, you can find it here, you can walk in and you can provide access to a computer to help you build that initial resume and help you do the job search to see what is available. There’s no obligation. Just go ahead in and look. And then the Protection and Advocacy for Beneficiaries of Social Security, remember we talked about that accommodation, if you request an accommodation and it is reasonable and your employer says no, if you cannot do this job the way everybody else does it, you cannot have a job, That PABSS program is legal wing that can challenge that if you want to and again that is your choice also. But all of these services can be found on the find help age within Social Security.gov. Use that link. Use the employment team. You can limit your search pick if you only want to find ENs, just click the EN button to find those and the benefits planners, just click those also. You can limit searches by a geography, you can limit services by type, you can limit by the type of services you need or the language that you need to help those services provided. Remember that is all in the Find Help link. Here you go. Find Help, two tools, different ways to search. You can take a guided search, it asks a series of questions And provide a list of service providers to fit, That’s a great tool. I use this find help tool all the time. And in your direct search, to find out who is available in my ZIP Code. I need somebody who speaks Spanish I am more comfortable dealing in my native language so we can find a for you also or how about the type of disability? If I have a mental impairment, I really do not want to deal with somebody who deals only with physical impairments. I’d rather have somebody who fits my personal situation. And you can do that.You know, here are some sites and tools you can use, tips and questions that you might want to ask when you are selecting a provider. The Ticket to Work is like a shopping past. You can go and talk to for five ENs in your area, who do you like best, who you think you’re going to be able to work best with, who do you think is going to offer you the best deal, the best services to suit your situation, finding an EN and assigning your ticket is one link that is in your pod and choosing the right EN for you is the second link. But there’s a lot of information here, a lot of information you can use to really do a great job when you are picking that employment team. We always have a success story. Today we have Amy’s story. Amy grew up with a developmental disability and she knew she wanted to work and she wanted to be sure what her options are and that is just the kind of person we want. She is interested in working when she is receiving the benefits. She received services from her state VR agency to find work and later worked with an EN and continues to help her develop her career and receive benefits counseling.  Perfect mix as far as I can see. She learned that she was eligible for Medicaid while working that 1619b program which allowed her to focus on her work goals without worrying about losing her health care coverage. That is a great success story. I would love to see your picture and your facts up here when you become that success story. Derek, we are back to questions.
Derek >> Thanks, Ray. Thank you for going through what we call the employment team that is available. It’s super helpful and I love hearing about Amy as a success story. Let’s go back to the benefits planning and counseling. A few questions have come in as a kind of follow-ups there. First, is there any fee or cost associated with accessing benefits planners.
Ray >> Not at all.
Derek >> Thanks, Ray.  It is great to know that these services are free and when people are contemplating a lot of the information that you have sent and delivered today, if they need to follow up on that, these are the right folks to reach out to. There’s another question, you mention the benefits of services coming from vocational rehabilitation from the Employment Networks. We get this one a lot. Can I work with both VR’s and the Employment Networks?
Ray >>You can but not at the same time. You know, the Employment Networks, you know, require that you assign your ticket to the network. And once you do that, that is who you are working with. You always have the right to take the ticket back and assign it to somebody else should something happen. But state VR can provide you with services regardless of your ticket status. But if you want to use the ticket and use and assign mean two different things, use it just means Social Security is aware that you have it. They are going to use that ticket for their payment and as you move through, because it is not assigned to VR, once VR closes your case, and that case closes after you have successfully worked in substantial gainful employment for 90 days, they are going to close your case. If you believe you need continuing, on-the-job, or off the job support, you can then assign your ticket to the Employment Network. It is called Partnership Plus and it is an exceptional program.
Derek >> This is Derek.  Thanks, Ray. I appreciate the description and knowing how to work first with vocational rehabilitation agency and then with the follow-on supports from and Employment Network. Towards the end there, you went to some of the benefits that an individual can receive from an Employment Network, the services. Can you revisit what happens after I start working, like a the support that are available from an EN I work with after I begin my work, anything in particular that you would really call out a benefit there?
Ray >> You know, there are a lot of services. You know, once VR closes your case, you know, you have lost any job coaching services that VR was providing, you know, what if you just need somebody to talk to? You know? What happens, you know, if you do request an accommodation and your boss says no? You know? That would cause the need for some help or some discussion about it, anyway. That Employment Network can provide that. What about, I’m trying to think about what us we have to do. Those are the big ones. I’ve been getting a continued on-the-job support, if you had a job coach for five hours a week when you case was being closed and you are uncomfortable leaving that job coach behind, the Employment Network can help arrange that service to continue. It might not be five hours a week pick it might be two hours a week pick it might only be only one hour week on Monday but that support can continue. And again, problems with your employer, what if you have gone to your supervisor somebody on the job isn’t treating you with respect. That is a tough discussion to have, too. You might want to talk to the Employment Network about that. You can see how you best approach this. There are a lot of issues that come up as you are beginning to learn a job, issues about what the break room looks like, you know, where things posted, where our the shifts being posted, you know, if they posted at the top of a bulletin board and I am using a wheelchair, I can’t see that far, you know, is there reasonable accommodation, yeah, that reasonable accommodation has moved down a few feet and pushed that thumbtack in a little bit lower. Are you aware that you have to have that discussion with somebody? Are you nervous about having it? ENs provide that type of support. And let me tell you, we have all had questions like that and it would have been helpful to have somebody to talk to.
Derek >> Thank you, Ray.  This is Derek speaking again. It always happens that we need to move to wrap up and we are out of time for my questions and I would just like to thank you again for providing us this really important and valuable information in the program and in particular today about the impact of choosing work has on Medicare Medicaid benefits and about the employment team itself and thinks again for being with us and for all your knowledge here today.
Ray >> You are more than welcome. It is a pleasure. Okay.
Derek >> I am now going to turn to provide some important ways to stay connected and as you know, we have learned a lot in the webinar and so if you want to get started on your path or continue to expand your search, we do have some important points of entry. First you can contact the Ticket to Work Helpline at 1-866-968-7842. Or you via TTY at 1-866-833-2967. Those lines are available Monday through Friday 8:00am to 8:00pm Eastern time. Secondly, you can visit the Ticket to Work website at any time at choosework.SSA.gov. You will find more details on the website regarding the topics covered today and will discover the Find Help tool that was described earlier. You can also find us on social media or subscribe to the blog or email updates by visiting https://protect-us.mimecast.com/s/KtaOCPN98mc5vnYgimk0qQ. This link is also in the web link spa that we’ve talked about in the bottom right corner under the Ticket to Work contact information. You can choose how to connect with us, your choice, and what we encourage you to do is to reach out and one or more of these three ways to explore a little bit further how to begin your path to employment. Next to get advice and encouragement and read stories about people who have achieved financial independence with help from the Ticket to Work Program, you can opt-in to receive text messages. If you are interested in receiving text messages from the Ticket Program, please text ticket to 474747. Standard messaging rates may apply. Another important note, if you need to contact Social Security’s Ticket to Work Program managed by the Social Security administration’s office of employment supports, we ask you to do that electronically instead of by postal mail. Our email address is support@choosework.SSA.gov. Remember to please not include personal identifiable information in your email, PII, any data that could potentially be used to identify a particular person. Examples of PII include a full name, Social Security Number, and an email address. So again, please do not include PII in your emails to us. You may also contact, of course, the Ticket to Work helpline at 1-866-968-7842 or via TTY at 1-866-833-2967. The helpline and that staff is available Monday through Friday 8am to 8pm Eastern time. We are also pleased to share information on the Affordable Connectivity Program, an effort to Help more Households Get Access to Broadband. The Affordable Connectivity Program is a Federal Communications Commission benefit program that helps ensure that households can afford the broadband they need for work, school, healthcare and more. The Program provides eligible households with a discount on broadband service and connected devices. And also provides a discount of up to $30 per month toward the internet for eligible households and up to $75 per month for homes on qualifying Tribal lands. To find out if you are eligible for the program and discover how to apply, please go to: www.fcc.gov/acp. Please join us for our next WISE Webinar which will be held on Wednesday, November 16, 2022 from 3-4:30 PM Eastern time. The topic will be: Working from Home with Ticket to Work. Registration is now available at https://protect-us.mimecast.com/s/LgVICQW2RJcNBLGVFOT4pl or call 1-866-968-7842 or for TTY 1-866-833-2967. And finally, your feedback is very important to us in planning for future webinars. Please provide your feedback and tell us what you think by taking our survey! To take the survey, you can follow the link that will pop up after the webinar, or you can find the survey link in the weblinks pod or by visiting the website at https://protect-us.mimecast.com/s/zPxxCR607YugnX9YfEGatC. Thank you for attending today to learn about the Ticket to Work Program and Support on Your Journey to Employment. Please know there are supports and people ready to help and we encourage you to reach out to begin your journey. This concludes today’s webinar.