Keeping Your Healthcare: Navigating Medicaid & Medicare in 2026

If you’re receiving SSI or SSDI, the fear of losing your health insurance is often the biggest hurdle to starting a job. We hear it all the time from the job seekers we partner with: "Is a paycheck worth losing my safety net?"

At Advocations, we’re here to bust that myth. The system is complex, but in 2026, the protections are stronger than ever. You don’t have to choose between a career and your health.

Medicare: The 8-Year Guarantee (SSDI)

If you receive SSDI, your Medicare doesn't just "stop" because you got a job.

• The Trial Work Period (TWP): You can earn any amount for 9 months (earning over $1,210/mo in 2026) and keep your full SSDI check and Medicare.

• The 93-Month Extension: After your trial period ends, you are guaranteed at least 93 more months (over 7 years) of premium-free Medicare Part A.

• The "Buy-In" Option: Even after those 8+ years, you can choose to "buy in" to Medicare to keep your coverage permanently as long as you still have a disability.

Medicaid: High Thresholds & "Buy-Ins" (SSI)

For those on SSI, Medicaid is protected by Section 1619(b). This rule allows you to earn a significant paycheck while keeping your Medicaid for free.

• 2026 State Thresholds: In most states, you can earn between $40,000 and $84,000 annually and keep your Medicaid.

• Medicaid Buy-In Programs: If you earn above your state’s limit, almost every state now offers a "Buy-In" program. These allow you to keep full Medicaid coverage by paying a small, income-based premium—often less than a monthly utility bill.

How "The A-Team" Protects Your Coverage

Navigating these limits alone is where the "oh-no" moments happen. Our Career Coaches act as your benefit bodyguards by simplifying the jargon and managing the technicalities:

• Medical Review Protection: By assigning your "Ticket" to us, the SSA will not start a medical review of your disability. Your status is protected while you work.

• Calculating IRWEs: We help you deduct Impairment-Related Work Expenses (like specialized tech, co-pays, or transportation) to keep your "countable" income below the limits.

• Reporting Support: We ensure your earnings are reported accurately so there are no surprise overpayments or "scary mail" from the SSA.

Don’t Panic—We’ve Got This

The paperwork is intimidating and the deadlines are heavy, but you don’t have to navigate them alone. We work different because we believe your health should never be a trade-off for your professional independence.

Ready to find out exactly how much you can earn in your state without losing your coverage?

Book a consultation with an Advocations Career Coach today.