People with disabilities can return to work through the Ticket to Work program. This program was established by the Ticket To Work and Work Incentive Improvement Act in 1999.12 It allows disabled workers to assess their ability to work and not lose their access to healthcare. The disability determination made by the Social Security Administration (SSA) determines the worker’s eligibility for the program.

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This program was created to address concerns over how few Social Security Disability Insurance (SSDI or Supplemental Security income (SSI), recipients could leave the disability rolls and go to work to earn a living. Beneficiaries who wanted to work were limited to one option: A state vocational rehabilitation agency (VR), which works with both public and private sector employers to assist individuals with disabilities in their transition to the workforce. Over 1 million people with disabilities receive services from state VR agencies in the United States each year.

Ticket to Work’s key provision addresses a major concern for many Social Security Disability recipients: losing their health care coverage. Participants in the program can continue to have Medicare coverage for up to eight and a quarter years after they return to work.2 SSDI beneficiaries who are working qualify for premium-free Part B, which covers hospitalizations. Individuals can still get Medicare Part B, but they must pay for it unless the coverage is provided by another party.

Understanding the Ticket to Work

Ticket to Work, a voluntary and free program, supports disabled workers 18-64 with job placement training and other services to help them succeed in the workplace. This program is designed to assist disabled workers in achieving financial independence and not rely on benefits from the SSA.

The maximum SSI federal cash payments to individuals for 2022 are $841 and $1,261 respectively. Social Security Disability payments, also known as SSDI, for workers average at $1,358, depending on how many dependents. The SSA will hold participants accountable for achieving specific goals within a timeframe.

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Participating in Ticket to Work Employment

Participants in Ticket to Work can search for employment opportunities and resources through an employment network, or a VR agency. An employment network (EN), is a group of non-profit organizations, government agencies, and employers that offer services to Ticket to Work participants. These include job placement advice and training, career advice, and support for the workplace.7 VR agencies are state-level programs that offer education, skills training, as well as other assistance for those who require more help for work.

Program incentives

Many people with disabilities who receive SSI and SSDI benefits are concerned about losing their health insurance. Ticket to Work provides individuals with continued coverage under Medicare and Medicaid as long as they continue to pay premiums up to 93 month after receiving SSI/ SSDI payments.

Important to remember that beneficiaries may be eligible for lower rates through the Affordable CareAct (ACA) or their state’s insurance marketplace. If they cancel Medicare after receiving payments, they cannot get back on Medicare unless approved for SSI/SSDI through expedited reinstatement. If they are unable to qualify for medicare, they will have to sign up again for Medicare during the general enrollment period.

Other Work Incentive Programs

The SSA offers several work incentives that can be used to assist individuals with disabilities to get back into work. These include the extended eligibility period (EPE), trial work period (TWP), and expedited reinstatements. The EPE and TWP only apply to SSDI benefits. They do not apply to SSI benefits. Both SSDI and SSI benefits are eligible for EXRs. If you’re on benefits, and you have worked at any time before now, you should verify that your TWP months are still available by calling your local SSA office.

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The Trial Work Period: What You Need to Know

The TWP (trial work period) is a nine-month period in which the beneficiary will receive their entire check, regardless of how much they earn. These nine months don’t have to be consecutive. If the beneficiary earns more than $970 per month through W-2 employment, has net earnings of self-employment over $970 per month, or works more hours than the monthly limit for self-employment, a month of earnings is considered a TWP. The beneficiary enters the extended period (EPE) immediately after the nine-month TWP is over.

How the Extended Period of Eligibility works

Extended period of eligibility (EPE), a 36-month period in which a beneficiary still has Social Security benefits, even if they earn less than the SGA limit. If they earn more than the SGA limit, they are not eligible for their check. The SGA is calculated based on gross earnings from W-2 income and net earnings earned by self-employment.

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How long can a ticket holder receive health benefits?

Workers can apply for Medicare coverage even if their benefits have ended. Participants can continue to receive healthcare for a further 93 months even if they stop receiving cash payments. Participants can apply for coverage at a reduced cost through Medicare Savings Programs after the free coverage period. You may be eligible for Medicaid depending on where you live and your income.