This is a plain-English walk through one number in Social Security's own published policy. It is not legal or benefits advice, and whether it applies to you depends on facts this article cannot know. Innovative Placements is a connector — we help people with disabilities find work in Western New York — and we are not benefits counselors. A WIPA counselor can run this against your actual earnings and your actual medical costs, at no cost to you. That is the call to make after reading this.
Section 1619(b) gets mentioned in a lot of places, including three articles on this site. It is usually described the same way: a rule that lets many people keep Medicaid after their SSI cash payment stops because of work. That description is correct and it is missing the part people actually need, which is the number.
There is a specific dollar figure for New York, Social Security publishes it, it changes every year, and nobody had written it down here. For 2026 it is $68,654.
What the Number Is
Social Security calls it a threshold amount, and it is state-specific. It is the annual earnings level the agency uses as a screening figure: below it, the 1619(b) protection generally continues; above it, Social Security looks harder rather than simply stopping.
The 2026 chart, published in the agency's own operating manual, gives the New York figure as $68,654, built from three components it also prints: a state supplement component of $2,088, a base amount of $26,964, and an average Medicaid figure of $41,690.
That breakdown is worth a glance, because it tells you what the number is for. Roughly two-thirds of it is not about your income at all. It is the state's average per-person Medicaid cost, which is there because the whole point of the threshold is to ask whether your earnings have reached the level where they could plausibly replace the medical coverage you would be giving up.
The published formula is: twice the annual state supplementation rate, plus twice the federal benefit rate, plus a work-expense component, which together give the base amount — and then the state's average per capita Medicaid expenses are added on top. Two states with identical benefit rates can therefore have very different thresholds, purely because their Medicaid costs differ.
The Part That Matters Most
Here is the sentence to carry away, because getting it wrong in either direction is expensive.
This is a screening figure, not a cliff. Earning above the threshold does not automatically end Medicaid. Social Security can set an individualized threshold for a person whose actual medical costs are higher than the state average — and for someone with substantial medical needs, that individual figure can be considerably higher than the published one.
So the honest framing is: $68,654 is where the standard screen stops applying, not where coverage stops. If your earnings approach it, the correct response is a conversation with a benefits counselor about your own numbers, not a decision to turn down hours.
People turn down promotions over this. The reasoning is usually a half-remembered version of a real rule — that earning too much ends Medicaid — without the two things that make it survivable: the threshold is far higher than most people assume, and it can be individually adjusted upward. Declining work on a number you have not checked is the expensive mistake here.
Something the Agency Says About Its Own Number
One detail from the published chart deserves repeating, because it is the kind of thing that usually gets edited out of a summary. Social Security notes that the 2026 threshold amounts were calculated using 2023 average per capita Medicaid expenses, because the 2024 data was not available.
That does not make the number wrong or optional — it is the operative figure, and it is the one that will be used. It is worth knowing because it tells you the threshold is a considered administrative estimate rather than a live measurement, which is a useful thing to understand about any figure your benefits depend on.
What It Is Not
Two clarifications, since both cause real confusion.
It is not the Medicaid Buy-In. New York has a separate program — the Medicaid Buy-In for Working People with Disabilities — which is a different route to keeping coverage while working, with its own rules and its own income tests. 1619(b) applies to people whose SSI cash stopped because of earnings. The Buy-In is a program you enroll in. Our guide to the Medicaid Buy-In covers that side; a benefits counselor can tell you which fits your situation, and for some people the answer changes over time.
And it is not a cap on what you may earn. Nothing about 1619(b) limits your wages. It describes the point at which one particular protection stops being applied automatically. You may earn whatever your job pays.
What to Do With This
Three things, in order.
Know roughly where you are. If your annual earnings are nowhere near $68,654, this number is not your immediate concern and you can stop worrying about it specifically. That is worth knowing on its own, because a vague fear of an unnamed limit does more damage than a named one.
If you are approaching it, get your own figure. This is exactly what WIPA benefits counseling exists for, and it is free. A counselor can look at your earnings, your medical costs, and whether an individualized threshold applies to you.
Check the number rather than trusting this article's copy of it. The chart is republished annually and the figure moves. An article is a snapshot; the agency's current chart is the authority.
Three articles on this site mention 1619(b) and none of them names the threshold. That is a common shape for benefits writing: the rule gets explained and the number stays somewhere else, so a reader finishes reassured and still unable to work out whether it applies to them. The number is the part that turns a rule into a decision.
Where to Take It
Questions about your own threshold, and about whether an individualized one applies, belong with a WIPA benefits counselor or your local Social Security office. Questions about New York Medicaid specifically can also go to a health insurance counseling program. If a decision has already been made that you believe is wrong, that is the point at which a legal services organization is the right call; our legal resources guide lists where to start in Western New York.
What we can do at Innovative Placements is the employment half: helping people find work that fits, without the search being shaped by a number nobody has looked up. Our overview of SSI and SSDI work incentives puts 1619(b) alongside the other provisions it works with, and Ticket to Work covers the program many people reach this question through.
The threshold figure and its components are from Social Security's Program Operations Manual System, section SI 02302.200, “Charted Threshold Amounts,” transmittal TN 38 (01-26), effective 01/20/2026, read directly from the agency's published text the day this article was posted. The note about the 2026 figures being calculated from 2023 Medicaid data is the agency's own. POMS is Social Security's operating instruction rather than statute, and the chart is republished annually: if this article ever disagrees with the current published figure, trust the current figure and tell us.