A Supplemental Security Income recipient who takes a job can lose the cash payment and still keep Medicaid, up to a limit that depends on the state. In 2026 that limit is $84,208 in Minnesota and $40,026 in Alabama, the lowest of any state, according to the Social Security Administration’s table of Section 1619(b) thresholds.
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A $44,182 gap between the highest and lowest state tables
The SSA threshold table for 2026 lists a separate figure for each state. Minnesota’s $84,208 is more than double Alabama’s $40,026, a difference of $44,182 in yearly earnings. Arkansas sits just above Alabama at $40,366, and Florida is at $42,946.
At the other end, Washington is at $73,897, the District of Columbia at $73,901 and Alaska at $73,070. New York stands at $68,654, California at $66,078 and Texas at $53,165. The Northern Mariana Islands, a territory rather than a state, has the lowest figure on the table at $29,412.
What special SSI status keeps in place
Under 20 CFR 416.264, the federal rule on special SSI eligibility status for Medicaid, a person in that status is treated as an SSI recipient for the purposes of “establishing or maintaining” Medicaid eligibility. That is the mechanism behind the headline: the monthly cash check can stop because of earnings while health coverage continues.
The threshold is the point where that protection ends. Earnings under the state figure leave Medicaid in place; earnings above it call for a separate look at whether the state figure should be replaced by an individual one.
How the Red Book builds a state figure
SSA’s Red Book chapter on SSI-only employment supports explains that each threshold is built from two pieces: the earnings that would stop SSI in that state, and the average annual per capita Medicaid expenditure for the state. A state with a higher earnings cutoff for SSI, or with higher Medicaid spending per person, can therefore produce a higher figure.
The table lists only the totals, not the two inputs behind each one, so the published numbers do not show which piece drives the difference between Minnesota and Alabama.
Reading the table without over-reading it
Each figure is a single dollar amount for a state, and the table does not adjust it for household size, the cost of living in a particular city, or the kind of job. The Red Book’s description treats the number as a state-level calculation, which is why an individual whose actual Medicaid costs are higher than the state average can end up with a different threshold from the one printed for the state. The Red Book lists those actual costs among the items an individualized threshold can add.
The thresholds are ceilings for a group, not predictions of what one worker earns. Spread over twelve months, $84,208 is about $7,017 a month and $40,026 is about $3,336 a month, so a part-time job at a modest wage sits well below every state figure, while a full-time job at a higher wage can approach the lowest ones. Where a given worker falls depends on the state, hours and pay.
The gap also shows how much geography matters. Two recipients with identical jobs and identical pay could face different Medicaid outcomes, one in Alabama and one in Minnesota, because the state number sets the line.
State figures differ, individual thresholds exist, and pay changes run on a 10-day clock
The first difficulty is that the figure to use is the one for the state of residence, and those figures range across more than $44,000. Someone who moves states, or who reads a neighbor’s number, can misjudge how much earning room remains. Earnings that exceed the state figure do not automatically end the analysis. The Red Book describes an individualized threshold that can take into account items such as impairment-related work expenses, actual Medicaid costs, a plan to achieve self-support and attendant care, so a worker above the table number has a further calculation to consider.
The second difficulty is reporting. SSA’s SSI reporting page says changes must be reported “as soon as possible and no later than 10 days after the end of the month in which the change occurred,” and lists starting or stopping work and any change in pay or hours among them. The page warns that “we may overpay you and you may have to pay us back,” and that late or missed reports can reduce payments by $25 to $100 for each unreported change.
Because a raise, a new job or a change in hours can shift both the cash payment and where earnings sit against the threshold, the reports and the threshold check run together. Reporting wages and changes to SSA directly is done with the agency itself and does not require paid help. The reporting page is the source for the 10-day rule and the penalties.
Work income, thresholds and wage reports in one place
The Medicaid threshold is only one of several numbers that move when an SSI recipient works, and the reporting deadline runs on a separate clock from the yearly table. Keeping wage changes, review dates and contacts in a single record limits the chance of a missed report.
The SSI & Disability Action Kit is a 10-page kit covering the rules for working without losing benefits and review and reporting steps, with an income and resource organizer for tracking the figures over time.
Keep wage reports and review dates in one income organizer →
This article was drafted with AI assistance and checked against the cited Social Security Administration and federal regulation pages.
