Your Benefits and Your Job

Health Care Options

When you get a job, you may get good health care coverage. The type of health care coverage you get will depend on your financial situation and employment status. Here we’ll explain some of your options once you get a job.

Coverage Through Work

Many, but not all, jobs offer health care benefits. If you get health coverage through your job, usually your employer pays most of the expenses. This means that your employer pays hundreds of dollars each month so that you have access to health care. Depending on your job, you may also have to pay a monthly amount in addition to what your employer spends. Details about health coverage through work are explained in the Benefits for Young People: Private Health Care Coverage section.

NC Medicaid Through SSI 1619(b) and Health Coverage for Workers with Disabilities (HCWD)

If you get NC Medicaid coverage and then get a job, you have a couple of options for keeping your NC Medicaid benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security’s 1619(b) program lets you earn up to $46,540 annually and still keep NC Medicaid coverage at no cost. That's a good deal!

If you don’t qualify for 1619(b), you may qualify for Health Coverage for Workers with Disabilities (HCWD), which lets you keep your NC Medicaid coverage. Depending on your income, you may have to pay a small premium for HCWD. You can read more about these options in the DB101 article about Benefits for Young People.

Remember that if you have NC Medicaid and get a job, it is very important that you report your income to your Department of Social Services (DSS) office. Learn more about how to report your income.

NC Medicaid and Individual Plans on HealthCare.gov

If your family’s income is at or below 138% of the Federal Poverty Guidelines (FPG) ($1,800 a month for an individual; $3,697 for a family of four), you may be able to get NC Medicaid coverage.

If you can't get employer-sponsored coverage or NC Medicaid, you can get individual coverage and the government may help you pay your monthly premium through tax subsidies, as long as you get your plan on HealthCare.gov. 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.

See DB101's Health Programs section to learn more about these programs. You can apply for them at HealthCare.gov.

Health Coverage Income Limits for Your Family

Your family size:	123456789101112
Income limits for your family:
	$15,650
	$5,500
	$15,060
	$5,380
	216
Income-based NC Medicaid, adults (138% FPG)
NC Medicaid for children (216% FPG)
Subsidized private plans, reduced fees (250% FPG)
Subsidized private plans (no income limit)	--
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. Notes: Some types of income do not count against these limits, including SSI benefits. Different programs sometimes use slightly different numbers for the Federal Poverty Guidelines (FPG). Disability-based NC Medicaid eligibility is not included here. For private plans with subsidies, your monthly premium amount depends on your income.

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Supplemental Security Income (SSI) Benefits

If you get Supplemental Security Income (SSI) benefits and then get a job, your monthly cash benefits amount will go down after you start working. Depending on how much you make, you may still get some cash benefits, because only part of the money you earn will be counted when SSI adjusts your monthly benefits. The SSI program does not count the first $65 you earn each month, and they only count about 50% of the rest. This means that a little less than 50% of your earnings will be counted when Social Security figures out your SSI benefits amount. So, if you don't earn too much, you will get paid by your job and still keep getting paid by SSI.

Depending on your situation, you may be able to use work incentives to keep getting some or all of your benefits. These include Plans to Achieve Self-Support (PASS), the Student Earned Income Exclusion (SEIE), and other incentives. You can read more about incentives and other benefits in the DB101 article about Benefits for Young People.

For detailed information about how work impacts SSI benefits, read DB101’s article about SSI. DB101’s School and Work Estimator can also help you figure out how your benefits might change after you get a job.

Reporting Your Income

When you get benefits and get a job, you must tell any government agency that gives you assistance that you are now working. This assistance might be cash benefits, health care, or FNS (Food Stamps). The agency giving you assistance might be Social Security, your Department of Social Services (DSS) office, or your local housing authority.

You will need to notify each agency of 3 things:

• The date when you started working
• How many hours you work each week
• How much you earn each month

Be sure to keep all pay stubs or direct deposit receipts. Social Security explains why and how you need to report your income. If you have questions, talk to a benefits planner.

Impairment Related Work Expenses (IRWEs) and Blind Work Expenses (BWEs)

Impairment Related Work Expenses (IRWEs) and Blind Work Expenses (BWEs) are expenses that you pay for yourself, which are related to your disability, and that you need so you can work. You can ask the Social Security Administration to deduct these expenses when calculating your income, so that your countable income is lower. Lower countable income can let you keep more of your SSI benefits while you are working. For more information on IRWEs and BWEs, Read DB101's article on SSI and Work.