Note: If your earnings are over this limit and you have high medical expenses, you might still qualify for 1619(b). Ask your local Social Security office about the 1619(b) Individualized Earnings Threshold.

• Would cost you, for your policy alone, less than 9.5% of your income for the monthly premium, and
• Meets bronze-level standards.

If you have an option that meets these standards, you and your family cannot qualify for government subsidies to get private insurance on Healthcare.gov. If your income is low enough, you may still qualify for Medi-Cal.

AJCCs can help you with various things, including:

• Giving you advice about local employers who are hiring
• Teaching you the basics of how to do a job search
• Helping you with your resume
• Practicing job interviews
• Showing you how to use online jobs websites like CalJOBS

Learn more about AJCCs or find a local America's Job Center of California (AJCC) (One-Stop).

Also called a "resource limit."

Also called "resources."

Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

According to the same law, an assistive technology service is:

Any service that directly assists an individual with a disability in selection, acquisition or use of an assistive technology device.

Payments are based on an individual’s income during the SDI program’s base period, which is prior to the onset of disability.

• For questions about work and your Social Security benefits, use Social Security's "Find Help" tool to locate a WIPA project near you. You can also call the Ticket to Work Help Line at 1-866-968-7842 / 1-866-833-2967 (TTY/TDD). The Department of Rehabilitation (DOR) also has Work Incentives Planners (WIPs).
• If you need assistance with your Medicare, the Health Insurance Counseling & Advocacy Program can help. HICAP provides free information and counseling to people with Medicare. You can call HICAP at 1-800-434-0222 or visit the HICAP website.
• If you need assistance with Medi-Cal and have a disability, you can contact Disability Rights California at 1-800-776-5746 or visit their website. You may also be able to get help with Medi-Cal from a local legal aid organization. The Health Consumer Alliance website has a lot of useful information about Medi-Cal, including a web page that can direct you to a local legal organization for assistance.
• If you have questions or need assistance with a program or benefit not listed here, contact an Independent Living Center. Independent Living Centers provide peer support and information on a wide range of topics for people with disabilities.

Tip: The BPQY is form number SSA-2459. If a Social Security Claims Representative does not know what a BPQY is, mention the form number.

For more information, refer to the Social Security Red Book, Special Rules for Persons who are Blind.

• Have a central visual acuity of 20/200 or less in your better eye, even while you are wearing a correcting contact lens or glasses in that eye; or
• Have a limitation in the field of vision of your better eye, so that:
  • You have a contraction of peripheral visual fields to 10 degrees from the point of fixation, or
  • The widest diameter of your visual field subtends an angle no greater than 20 degrees, or
  • You have a contraction of peripheral visual fields to 20% or less visual field efficiency.

Social Security and other agencies use this definition of blindness to decide if you qualify for benefits programs, such as Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Some people with vision impairments that do not meet these standards may still qualify for benefits.

The budget month may be the same as the current month, one month before the current month, or two months before the current month. Which month a program looks at depends on the program rules and your situation.

Note: DB101 Calculators use the correct budget month for each month and program.

Region I includes the more urban counties (Alameda, Contra Costa, Los Angeles, Marin, Monterey, Napa, Orange, San Diego, San Francisco, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Sonoma, and Ventura) where cost of living is higher, so the maximum benefit is correspondingly higher. Region II includes the more rural counties (all of the ones not listed above).

If you are under 30, you can sign up for a catastrophic plan on Covered California.

• Became disabled before turning 22, and
• Have a parent who died or who gets retirement or SSDI benefits.

Formerly known as "Disabled Adult Child" (DAC) benefits.

Legal residents who don't have I-551 or I-94 status may be eligible for some state programs, but not for Social Security programs. This could include Legal Permanent Residents (LPRs), refugees, asylees, conditional entrants, people certified as victims of trafficking, certain people whose immigration status is pending, people under Temporary Protected or Family Unity Beneficiary Status, Lawful Temporary Residents, applicants for asylum, people who have been granted or are applying for withholding of removal, and all other people with a lawfully residing immigrant status.

People who are undocumented or non-immigrants are not eligible for any of these programs.

For example, the SSI program uses a special calculation to determine your countable earned income, your total countable income, and ultimately, your SSI benefit.

Example: Supplemental Security Income (SSI) counts most unearned income, but a bit less than half of earned income. So, if you have $500 in unearned income and $500 in earned income, your countable income for SSI would be just $697.50, even though your total income would be $1,000. Other programs, such as disability-based Medi-Cal and Medicare Savings Programs often use calculations similar to SSI's.

Step 1: If you have unearned income (for example, an SSDI benefit), subtract a $20 "General Income Exclusion" from it to calculate your countable unearned income. If you do not have unearned income, this exclusion is applied to any earned income.

Step 2: If you have earned income (for example, wages), subtract a $65 "Earned Income Exclusion" from it (along with the remainder of the $20 "General Income Exclusion" that you have not applied to Unearned Income), along with any Impairment Related Work Expenses, and divide the resulting figure by two to find your countable earned income. If you have Blind Work Expenses, subtract them after you divide by two.

Step 3: Add your countable unearned income to your countable earned income to find your total countable income.

Different Medi-Cal programs may include more deductions or exclude certain types of income. See the program descriptions for details.

Step 1: If you have unearned income (for example, an SSDI benefit), subtract a $20 "General Income Exclusion" from it to calculate your countable unearned income. If you do not have unearned income, this exclusion is applied to any earned income.

Step 2: If you have earned income (for example, wages), subtract a $65 "Earned Income Exclusion" from it (along with the remainder of the $20 "General Income Exclusion" that you have not applied to Unearned Income), along with any Impairment Related Work Expenses, and divide the resulting figure by two to find your countable earned income. If you have Blind Work Expenses, subtract them after you divide.

Step 3: Add your countable unearned income to your countable earned income to find your total countable income.

Example: If you have $500 in unearned income and $500 in earned income ($1,000 total), your countable income for SSI would be: $480 in countable unearned income + $217.50 in countable earned income = $697.50.

When determining whether or not you qualify for SSI, Social Security excludes certain resources from your countable resource total. Your home and one car do not count as resources, for example. Income received from Earned Income Tax Credits (EITC), Child Tax Credits (CTC), CalFresh (formerly Food Stamps), grants, scholarships, fellowships, gifts, property essential to self-support, Individual Development Accounts (IDAs), and many other items may be excluded as well. Additionally, for SSI, the first $100,000 in an ABLE account are not countable resources.

For example, the SSI program uses a special calculation to determine your countable earned and unearned income, your total countable income, and ultimately, your SSI benefit.

There are four different levels of plans available to most people:

1. Platinum plans have the highest monthly premiums and the lowest out-of-pocket expenses when you get medical care.
2. Gold plans have slightly lower premiums and slightly higher out-of-pocket expenses when you get medical care.
3. Silver plans have lower premiums. The out-of-pocket expenses for medical services depend on your family’s income; if it is at or below 250% of the Federal Poverty Guidelines (FPG), the out-of-pocket expenses may be as low as a gold or platinum plan.
4. Bronze plans have the lowest monthly premiums and the highest out-of-pocket expenses when you get medical care.

You may see plans with percentages ranging from as low as 60% for Bronze plans to as high as 90% for Platinum plans. A lower percentage means the plan has higher out-of-pocket expenses when you get medical care, while a higher percentage means the plan has lower out-of-pocket expenses. Plans with lower percentage ratings usually have lower monthly premiums. Note: These percentages do not tell you exactly what percentage of your family's expenses your plan will pay for. They are based on averages for thousands of families and how much your plan actually ends up paying for your family could be much higher, or much lower, than what the percentage rating says, depending on the services your family needs.

Visit the VA.gov website.

To qualify for an exemption from Welfare-to-Work activities due to a disability, a CalWORKs recipient must provide verification from a physician that states the disability, its expected duration, and the extent to which it impairs employment and/or Welfare-to-Work activities. The individual must also actively seek medical treatment to qualify for an exemption.

There are two common levels of disability according to private insurers:

1. Own-Occupation Disability (or “Own Occ” ) means your disability prevents you from performing your own occupation, which means you cannot do the work or job you have been trained to do and have experience in
2. Any-Occupation Disability (or “Any Occ”) means your disability prevents you from performing any occupation:
   • Sometimes Any Occ means that your disability prevents you from performing any occupation that pays at least a specified percentage of what you earned before your disability

Own-occupation insurance policies pay you if you are unable to perform your own occupation, even if you are able to get a different type of job. They have higher premiums than policies that require you to be unable to perform any occupation. Check with your insurer to see which definition of disability your plan has.

A person must not only be unable to do his/her previous work but cannot, considering age, education, and work experience, engage in any other kind of SGA which exists in the national economy. It doesn't matter whether such work exists in the immediate area, or whether a specific job vacancy exists, or whether the worker would be hired if he/she applied for work. The worker’s impairment(s) must be the primary reason for his/her inability to engage in SGA.

• The immune system
• Special sense organs
• The skin
• Cell growth
• Digestive, genitourinary, bowel, and bladder functions
• The nervous system and brain
• Respiratory, circulatory, cardiovascular, endocrine, hemic, lymphatic, musculoskeletal, and reproductive functions

Generally, the only time it is required to disclose a disabling condition at the workplace is when requesting a reasonable accommodation. Even then, the requirement is only to present the employer with information demonstrating that a reasonable accommodation is needed for the person to perform the essential functions of the job.

• You live in the same residence
• Neither person is married to someone else, or is a member of another domestic partnership with someone else that has not legally ended
• You are not related by blood in a way that would make it illegal for you to be married to each other in your state
• You are both at least 18 years of age
• You are both members of the same sex, or one or both of you are over the age of 62 and meet the eligibility criteria under Title II of the Social Security Act for old-age insurance benefits, or Title XVI of the Social Security Act for aged individuals
• You are both capable of consenting to the domestic partnership, and
• You agree to go through the California courts to end the domstic partnership or legally separate, or any other legal decisions related to your partnership.

If you have a disability and get a housing benefit that has an EID rule, you can start working and your new earnings will not be counted by the program during the first year after you start working. That means your rent won’t go up and you won’t lose the benefit because of your work. During the second year after you start working, only 50% of your earnings will be counted.

Note: If you live in the same household as somebody else and the two of you act as though you are married and present yourselves to the community as being married, Social Security will consider you a married couple for SSI purposes. This is often referred to as "holding out."

Note: For SSI, Social Security only recognizes same-sex couples as married if they are legally married under California law. (The rules are different for SSDI.)

• U.S. permanent resident (has an Alien Registration Card or I-551 Card)
• Conditional permanent resident (has an I-551C Card)
• Refugee
• Asylum grantee
• Parolee, or
• Cuban-Haitian entrant with an Arrival Departure Record (I-94) from the Immigration and Naturalization Service (INS).

Employment Network examples:

• Employers
• Employers offering or arranging for job training
• Employers collaborating with community based organizations
• Transportation providers
• Staffing and placement agencies
• Consumer groups
• State Department of Rehabilitation
• Private providers of rehabilitation services
• Vocational rehabilitation Service Projects for American Indians with disabilities
• Cottage industries such as benefits planning services combined with other services
• Public or private schools providing transitional education or career development services
• Organizations working with ethnic, disability, or religious faith groups

A current list of Employment Networks can be found on the Ticket to Work website.

• Ambulatory patient services (care you get without being admitted to the hospital)
• Emergency services
• Hospitalization
• Maternity and newborn care (care before and after your baby is born)
• Preventive and wellness services and chronic disease management, including:
  • Immunization vaccines for many diseases
  • Screening for different conditions
  • Counseling for some health issues
  • Women’s preventive care
  • Children’s preventive care
• Prescription drugs
• Laboratory services
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Pediatric services for children, including oral and vision care

• Disabled for at least 30 days
• Under 16
• Under 19 and in school full-time
• Over 60
• Caring for a relative’s child who is a ward of the state or is in danger of being placed in foster care, and who requires care that prevents you from working
• At home because you are caring for a sick or injured household member
• Taking care of a baby under a year old
• Pregnant and medically unable to do Welfare-to-Work activities

Note: If you are exempt, you can still choose to get Welfare-to-Work help, if you want it.

If you earn more than SGA, your SSDI benefits will be suspended. However, during the EPE, you are eligible to have your SSDI benefits restarted if your earnings drop below SGA.

For the Supplemental Security Income (SSI) program and some other programs, whether an adult pays the fair share of expenses may affect benefits eligibility or benefits amounts.

Each year, the U.S. Department of Health and Human Services (HHS) issues the Federal Poverty Guidelines (FPG) in the Federal Register. The current FPG for one person is $12,760 per year; for two people, it's $17,240. Add $4,480 for each additional person.

Some agencies refer to these guidelines as the "Federal Poverty Level (FPL)" or "Federal Poverty Line (FPL)."

Note: Different state and federal programs adopt the new Federal Poverty Guidelines on different dates each year.

The window begins on the first TWP month, but rolls forward until you have worked nine Trial Work Months within 60 consecutive months.

• Inpatient hospital services (tests, surgeries, procedures)
• Outpatient hospital services
• Physician services
• Medical and surgical dental services
• Nursing services
• Home health care
• Family planning and supplies
• Rural health clinic and ambulatory services
• Laboratory and x-ray services
• Pediatric and family nurse practitioner services
• Nurse-midwife services
• Early and periodic screening
• Diagnosis and treatment (EPSDT) services
• Prenatal and delivery services
• Ambulatory services for individuals in an institution
• Home health services
• Clinic services
• Nursing facility services (under 21 years old)
• Intermediate care facility/developmentally disabled services
• Optometrist services and eyeglasses
• Prescribed medication
• TB-related services for TB infected persons
• Prosthetic devices
• Dental services
• Preventative and rehabilitative services
• Case management
• Private duty nursing
• Home respiratory care services
• Personal care services
• Home and community based waivers
• Medical equipment and appliances
• Diagnostic screening

HIPAA also prevents group health plans from denying you coverage based on your health condition and provides protections for those buying individual health coverage. However, these parts of HIPAA are protections that are no longer needed, since the Affordable Care Act provides all the same protections, plus more.

If a person enrolls in a Medicare supplement during the Medigap open enrollment period, an insurance company cannot use health screening. But, if a person tries to enroll in a Medicare supplement outside of the open enrollment period, then a private insurance company can still use health screening.

The exact rules for who counts as a member of a household depend on the program. For most programs, your household includes the following people if they are living with you:

• Yourself
• Your spouse
• Your children
• Your spouse's children

If you are under 18, for most programs your household also includes the following people if they are living with you:

• Your parents
• Your stepparent if your other parent lives with you
• Your siblings and stepsiblings

Many programs also consider these people part of your household if you over 18. And for some programs, other people living with you, such as grandparents, cousins, or others, may also be considered part of the household.

The government may help individuals and families with low to middle income who get their coverage through Covered California pay for their monthly premiums and a portion of the cost of approved medical services.

Starting in 2019 there is no tax penalty if you don't have coverage.

Note: The state of California has its own individual mandate. Learn more about the California individual mandate and tax penalty.

If you do not pay your fair share of food and/or shelter, your maximum possible SSI benefits amount may be reduced. Depending on your situation, your ISM may be calculated using SSI's Value of One-Third Reduction (VTR) rule or the Presumed Maximum Value (PMV) rule.

Note: ISM rules usually only apply to adults, not to children under 18 years old. For children, parent-to-child deeming rules usually apply instead.

There are two levels of the Low Income Subsidy:

• The full subsidy is for people who also get Medi-Cal coverage or who are in a Medicare Savings Program (MSP). You may also qualify if your countable income is less than $17,226 per year and your resources are less than $7,970, if you are single (the limits are higher for larger households).
  • With the full subsidy, you will not have to pay a Part D premium or deductible, and there may be lower copayments.
• The partial subsidy is for people who can’t get the full subsidy, but have less than $19,140 in countable income and less than $13,290 in resources, if you are single (the limits are higher for larger households).
  • With the partial subsidy, you will pay 0%, 25%, 50%, or 75% of the Part D premium, depending on your income, and will only have to pay a $92 deductible before you get help paying for drugs. You will have to pay coinsurance and copayments for your medications, but they will be lower than they would be without the partial LIS.

Note: Not all of your income and resources are counted when you apply for the Low Income Subsidy. You can apply for the LIS even if you are not sure that you will qualify.

With managed care, you have a primary care provider who oversees your care and refers you to specialists within the network when needed.

Depending on your disability, your medical provider can be a:

• Licensed medical or osteopathic doctor
• Medical officer at a U.S. government facility
• Chiropractor
• Podiatrist
• Optometrist
• Dentist
• Psychologist
• Nurse practitioner or physician assistant (after examination and collaboration with doctor or surgeon)
• Licensed midwife, nurse-midwife, or nurse practitioner for normal pregnancy or childbirth, or
• Accredited religious practitioner

The Affordable Care Act prohibits health insurance companies from doing medical underwriting and excluding pre-existing conditions from coverage. Other forms of insurance, like private disability insurance, can do medical underwriting and exclude pre-existing conditions.

Also known as "Medicare Managed Care Plan."

There are three different Medicare Savings Programs you may qualify for:

• Qualified Medicare Beneficiary (QMB), if your countable income is 100% of FPG or less ($1,064/month for an individual, $1,437/month for couples)
• Service Limited Medicare Beneficiary (SLMB), if your countable income is 120% of FPG or less ($1,277/month for an individual, $1,724/month for couples)
• Qualified Individual (QI), if your countable income is more than 120% of FPG, but at or below 135% of FPG ($1,436/month for an individual, $1,940/month for couples)

Medicare supplement plans are available only to individuals using the Original Medicare Plan, and it is illegal for an insurance carrier to sell a Medicare supplement to an individual who does not have Original Medicare.

Medicare supplements are also referred to as "Medigap."

The MBSAC is a limit that is compared to your countable income. If your family’s countable income is lower than the MBSAC for a family in your situation, your family will be eligible for a CalWORKs cash benefit. The MBSAC limit depends on how many people are in your family and whether you live in Region 1 or Region 2.

Region I includes the more urban counties (Alameda, Contra Costa, Los Angeles, Marin, Monterey, Napa, Orange, San Diego, San Francisco, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Sonoma, and Ventura) where cost of living is higher, so the MBSAC is correspondingly higher. Region II includes the more rural counties (all of the ones not listed above).

Note: THE MBSAC limit is not your benefit amount. Is is simply a tool to determine whether your family is eligible for CalWORKs.

MAGI includes:

• Wages, salaries, tips, and other earned income
• Taxable interest, dividends, business income, and capital gains
• Social Security Disability Insurance (SSDI) benefits and Social Security retirement benefits of people who file taxes
• Unemployment compensation; and
• Most other types of taxable income.

MAGI does not include:

• Supplemental Security Income (SSI), CalWORKs, CalFresh, and veterans' disability benefits
• Workers' compensation
• Earned income that is placed in a 401(k) plan or Individual Retirement Account (IRA) (Income placed in Roth versions of these accounts is included in MAGI.)
• Pre-tax deductions from a paycheck, including contributions to health savings accounts (HSAs) and flexible spending accounts (FSAs)
• Child support received; and
• Most other types of non-taxable income.

Get more information about what is included in Modified Adjusted Gross Income.

Individuals with Medicare choose to either stay in Original Medicare or enroll in a Medicare Advantage Plan. Medicare Advantage plans will have different costs and covered services than Original Medicare.

Find a PASS specialist in California.

• Is expected to last continuously for at least 12 months (one year) or result in death, and
• Prevents a person from performing any Substantial Gainful Activity (SGA) (earning more than $1,310 per month; $2,190 if blind).

• Subject to an Order of Supervision
• On whose behalf an immediate relative petition has been approved and who are entitled to voluntary departure
• Who have properly filed an application for an adjustment to lawful permanent resident status
• Granted a stay of deportation
• Granted voluntary departure and who are awaiting issuance of a visa
• In deferred action status
• Who entered and have continually resided in the United States since before January 1, 1972

A PASS specialist can help you set up a Plan to Achieve Self-Support.

The Affordable Care Act prohibits health insurance companies from doing medical underwriting and excluding pre-existing conditions from coverage. Other forms of insurance, like private disability insurance, can do medical underwriting and exclude pre-existing conditions.

The Affordable Care Act prohibits health insurance companies from doing medical underwriting and excluding pre-existing conditions from coverage. Other forms of insurance, like private disability insurance, can do medical underwriting and exclude pre-existing conditions.

If you're on SSDI or CDB and Medicare, you likely won't have to pay a premium for Medicare Part A coverage. You may have to pay a Part B premium, however. For most people, the premium for Part B coverage is $148.50 per month or a bit less, depending on their situation. If you qualify, a Medicare Savings Program or other programs can help pay for your Part B premium.

If you sign up for Part D prescription drug coverage or have a Medicare Advantage (Part C) plan instead of Original Medicare, you will also usually have to pay a premium. The exact amount of your premium will depend on the plan you choose.

The PMV rule applies if:

• Somebody helps you with food and/or shelter, and
• The Value of One-Third Reduction (VTR) rule does not apply to your case.
  • Examples: The VTR does not apply if you do not live in the same household as the person helping you with your food and shelter, or if the person helping you does not help with both food and shelter.

The exact amount your maximum SSI benefits go down depends on your situation:

• By default, it will go down by one-third of the maximum SSI benefit plus $20. For 2021, this Presumed Maximum Value (PMV) is $284.67 for an individual.
• However, if the actual help you get paying for food or shelter is worth less than the PMV, then your SSI benefits will only be reduced by the actual support amount.

The SSA may find you presumptively disabled if you meet the medical criteria of the Blue Book Listing of Impairments or if you have HIV/AIDS and meet the criteria of SSA Form 4814. In either case, you must also meet SSI financial requirements to be eligible for presumptive disability benefits.

Repayments of presumptive disability benefits are not required even if SSI benefits are ultimately denied.

In some cases, the federal government may help low to middle-income families pay for private health coverage through tax subsidies if they are in very specific situations and do not have other affordable health coverage alternatives.

If you get an apartment from a project-based housing program, you do not get to choose which apartment you will live in. With many project-based programs, you will pay about 30% of your income as rent, and the program will pay the rest.

The Section 8 project-based voucher (PBV) program is a large project-based housing program. Other project-based housing is available through HUD Homeless Programs, Section 202, and Section 811.

• Property that you use in a trade or business (for example, your inventory) or personal property you use for work as an employee (for example, tools or equipment)
• Up to $6,000 of the value of nonbusiness property that you use to produce something that helps with your daily living (for example, land that you use to produce vegetables that you eat)
• Up to $6,000 of the value of property if the property gives you a return of at least a 6% per year (for example, property you own and rent to someone else)

You must be using the property to support yourself or expect to start using it again within a reasonable period of time, usually 12 months.

Find public housing authorities near you.

• Be less than 65 years old,
• Be eligible for Medicare Part A,
• Have countable income that's 200% of the Federal Poverty Guidelines (FPG) or less ($2,127 or less per month for individuals, $2,874 or less for couples),
• Have assets at or below the limit ($4,000 for individuals, $6,000 for couples), and
• Meet all other Medi-Cal eligibility requirements.

• Be eligible for Medicare Part A and B
• Have countable income that's 135% of the Federal Poverty Guidelines (FPG) or less ($1,436 or less per month for individuals, $1,940 or less for couples),
• Have resources at or below the limit ($7,970 for individuals, $11,960 for couples), and
• Meet all other Medi-Cal eligibility requirements.

• Be eligible for Medicare Part A and Part B,
• Have countable income that's 100% of the Federal Poverty Guidelines (FPG) or less ($1,064 or less per month for individuals, $1,437 or less for couples),
• Have resources at or below the limit ($7,970 for individuals, $11,960 for couples), and
• Meet all other Medi-Cal eligibility requirements.

This program does not apply benefits retroactively.

• Relationship — the taxpayer’s child or stepchild (whether by blood or adoption), foster child, sibling or stepsibling, or a descendant of one of these.
• Residence — has the same principal residence as the taxpayer for more than half of the tax year. Exceptions apply, in certain cases, for children of divorced or separated parents, kidnapped children, temporary absences, and for children who were born or died during the year.
• Age — must be under the age of 19 at the end of the tax year, or under the age of 24 if a full-time student for at least five months of the year, or be permanently and totally disabled at any time during the year.
• Support — did not provide more than one-half of his/her own support for the year.

For employees, qualifying events can include:

• Quitting
• Being fired for a reason besides gross misconduct
• Being laid off
• Having your work hours reduced

If you are covered under your spouse’s employer-sponsored health coverage, you can get continuation coverage if your spouse loses coverage for any of the above reasons or because:

• The employee dies
• There’s a divorce or legal separation
• The employee becomes eligible for Medicare

In education, a reasonable accommodation is a modification that allows a student with a disability to successfully participate in an activity, class, test, or other aspect of school.

• Attend a college or university for at least eight hours a week under a semester or quarter system
• Be in grades 7 - 12 for at least 12 hours a week
• Be in a course of training (with shop practice) for at least 15 hours a week to prepare for a paying job
• Be in a course of training (without shop practice) for 12 hours a week

In some circumstances, like illness or unavailability of transportation, students may be allowed to spend less time than indicated above and still be considered “regularly attending” for the purposes of the SEIE.

If you're on Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY), or visit your local Social Security office, and ask what's the best way for you to report. Note: Reporting rules for SSI and SSDI are different and if you get both benefits, you must report income for them separately.

If you're on Medi-Cal or any other state health coverage or cash assistance program, report any changes in earnings to your county social services agency.

• The home, and any adjoining land
• Household goods and personal effects that have a total value of $2,000 or less
• One car if it is: necessary for employment, or necessary for medical treatment, or modified for use by a disabled person, or it provides necessary transportation to perform essential daily activities, or has a current market value less than $4500
• Property of a trade or business that is essential for self-support
• Non-business property which is essential to self-support
• Resources of a blind or disabled individual necessary to fulfill an approved PASS
• Certain stocks held by Alaskan natives
• Life insurance, if the total face value of all policies on one person do not exceed $1500. Otherwise, the cash surrender values of life insurance policies will count as a resource
• Restricted allotted Native American lands
• Payments or benefits paid under other Federal statutes
• Disaster relief assistance
• Burial space of any value, and burial funds up to $1500
• Title XVI (SSI) or Title II (SSDI) retroactive payments for 6 months
• Housing assistance
• Earned Income Tax Credits
• Nine months of payments received as compensation for expenses or losses suffered as a result of a crime
• Nine months of reallocation assistance

For more information, you can read the SSI Spotlight on Resources.

Also called an "asset limit."

Also called "assets."

Example: Julia's consulting business earns $5,000 per month, but spends $2,000 per month on expenses. Her company's total monthly revenue is $5,000; her company's monthly net income ($5,000 minus $2,000) is $3,000.

• The housing choice voucher program, which helps pay for rent in any privately owned housing that accepts a Section 8 voucher. This is the most common Section 8 program.
• Project-based Section 8, which also helps pay for rent in privately owned rental housing, but only in specific privately owned buildings.
• The Section 8 Homeownership Program, which helps buy a home and meet the monthly homeownership expenses.

• Social Security retirement benefits
• Social Security Disability Insurance (SSDI)
• Supplemental Security Income (SSI), and
• Childhood Disability Benefits (CDB).

Social Security offices also handle some aspects of Medicare.

To contact SSA, call 1-800-772-1213 or 1-800-325-0778 (TTY) or visit your local Social Security office.

Visit the SSA.gov website.

SSDI also offers benefits to family members, including children and widows, when a primary wage earner in the family becomes disabled or dies. Additionally, adults whose disabilities began before they turned 22 may be able to get Childhood Disability Benefits (CDB).

Learn more about Special Needs Plans on Medicare.gov.

Both the Special Needs Alliance and the Academy of Special Needs Planners can help you find an attorney who specializes in Special Needs Trusts.

• Be eligible for Medicare Part A and Part B,
• Have countable income that's 120% of the Federal Poverty Guidelines (FPG) or less ($1,277 or less per month for individuals, $1,724 or less for couples),
• Have resources at or below the limit ($7,970 for individuals, $11,960 for couples), and
• Meet all other Medi-Cal eligibility requirements.

• The first $20 per month
• Income set aside or being used for a Plan to Achieve Self-Support (PASS)
• State or locally funded assistance based on need
• Rent subsidies under HUD programs
• CalFresh (formerly Food Stamps) and other food or meal programs, and
• The first $60 of infrequent or irregularly received income in a quarter.

Social Security has a complete list of the types of unearned income that are not counted by the SSI program. Some of the SSI exclusions on the list are:

• AmeriCorps programs
• Burial Funds (Interest on Excluded)
• Child Care Assistance Under the Child Care and Development Block Grant Act
• Department of Education (DE) and Bureau of Indian Affairs (BIA) Student Assistance
• Disaster Assistance
• Educational Assistance
• Energy Assistance
• Federal Perkins Loan
• Federal Supplemental Education Opportunity Grants (FSEOG)
• General Assistance
• Gifts Occasioned by Death
• Gifts of Domestic Travel Tickets
• Grants, Scholarship, Fellowships, and Gifts
• Home Energy Assistance
• Home Produce
• Housing Assistance
• Individual Development Accounts (IDAs) (Demonstration Project)
• Individual Development Accounts (IDAs) (TANF Funded)
• Leveraging Educational Assistance Program (LEAP)
• Low Income Energy Assistance
• Pell Grants
• Private Nonprofit Assistance
• Refunds of Taxes Paid on Real Property or Food
• Relocation Assistance
• School Breakfasts
• School Lunches
• State Assistance Based on Need
• Women, Infants, and Children Program (WIC)

Families with income at or below 400% of the Federal Poverty Guidelines (FPG), $51,040 for an individual in 2021 ($104,800 for a family of four), may get federal tax subsidies to help pay for their health coverage premium.

Families with income at or below 250% of FPG, $31,900 for an individual ($65,500 for a family of four), may also get qualify to get health coverage with lower expenses, such as reduced copayments, coinsurance, or deductibles, as long as they choose to get a silver plan.

In 2021, SGA is $1,310 per month ($2,190 for people who are blind).

SGA levels for previous years:

Social Security lists the SGA levels for earlier years.

If you don't have coverage, the amount of the tax penalty will be $695 or 2.5% of your income, whichever is higher. If you have to pay the penalty, you will pay it when you file your California tax return.

Note: There used to be a federal tax penalty for not having health coverage. The federal tax penalty ended after 2018.

Starting in 2019 there is no tax penalty if you don't have coverage.

Note: The state of California has its own individual mandate. Learn more about the California individual mandate and tax penalty.

Ticket to Work offers free services, such as:

• Vocational rehabilitation
• Training
• Referrals
• Job coaching
• Job counseling
• Placement services

Learn more on the Ticket to Work website.

As long as an individual is making timely progress on the IWP, Social Security will not initiate a medical Continuing Disability Review (CDR).

Trial Work month income levels are indexed annually for increases or decreases in the average wage. Previous Trial Work month gross income levels were:

• $880 in 2019
• $850 in 2018
• $840 in 2017
• $810 in 2016
• $780 in 2015
• $770 in 2014
  
• $750 in 2013
• $720 in 2012
• $720 in 2011
• $720 in 2010
• $700 in 2009
• $670 in 2008
• $640 in 2007
• $620 in 2006
• $590 in 2005
• $580 in 2004
• $570 in 2003
• $560 in 2002
• $530 in 2001
• $200 from 1990 to 2000, and
• $75 before 1990.

Social Security rules do not penalize you for receiving unincurred business expenses. Instead, Social Security deducts the value of any unincurred business expenses from your net income when deciding if you have reached the Substantial Gainful Activity (SGA) level for any given month. SSA uses fair market value to assess the value of any unincurred business expenses.

Social Security rules do not penalize you for receiving unpaid help. Instead, Social Security deducts the value of any unpaid help that your business receives from your net income when deciding if you have reached the Substantial Gainful Activity (SGA) level each month.

Social Security looks at wage subsidy and special conditions when they make an SGA decision. They only use earnings that represent the real value of the work you perform to decide if your work is at the SGA level. If Social Security decides that wage subsidy or special conditions exist, you can earn more while continuing to get your benefits.

Wage subsidy or special conditions may exist if:

• You get more supervision than other workers doing the same or a similar job for the same pay
• You have fewer or simpler tasks to complete than other workers doing the same job for the same pay, or
• You have a job coach or mentor who helps you perform some of your work

Note that Social Security uses wage subsidy and special conditions rules when they are deciding if you have earned Substantial Gainful Activity after your SSDI Trial Work Period is over. Social Security does not use these rules during your Trial Work Period or in any Trial Work month.

• Subsidized or unsubsidized employment
• Work experience
• On-the-job training
• Work-study
• Self-employment
• Community service
• Vocational education and training
• Job search and job readiness assistance

The rest of the Welfare-to-Work requirement can be fulfilled with non-core activities, which may include:

• Adult basic education
• Job skills training directly related to employment
• Education directly related to employment
• Secondary school
• Mental health, substance abuse, and domestic violence services

The number of work credits needed to qualify for SSDI depends upon how old you were when Social Security determined that you are disabled.

If you were determined disabled before age 24, you need six credits within the past three years to be eligible for SSDI.

If you were determined disabled between the ages of 24 and 31, you need 12 credits within the past six years to be eligible for SSDI.

If you were determined disabled after you turned 31, you need the number of work credits shown in the table below. And unless you are blind, you need to have earned at least 20 of those credits in the 10 years prior to becoming disabled.

All public benefits in California have work incentives, including Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), Medicare, and Medi-Cal.