Derek >> As I mentioned, my name is Derek Shields. Sorry, as Jayme mentioned, I'm Derek Shields. I'll serve as the moderator. And we have with us today Raymond Cebula from Cornell University. He'll be our presenter. Ray received his law degree from the University of New Hampshire's Franklin Pierce School of Law and spent 23 years providing legal services to individuals with disabilities and their interactions with Social Security. Ray then became part of Cornell University's Work Incentive Support Center. And in 2005 joined the staff of Cornell's Yang-Tan Institute on Employment & Disability. Ray now serves as the program director for YTI Online. This is Cornell's Work Incentive Practitioner Credentialing Program. Ray, I'm very pleased to hand the webinar over to you and for you to be able to dive into today's agenda.

Ray >> Okay, thank you, Derek and I'm hoping you can all hear me. Today, we're going to talk about healthcare and healthcare is very, very important to all of you. And generally, as a benefits planner, I hear that people are more interested in keeping that healthcare than they are their cash benefits. So, we're going to talk about that. 
We're going to cover the Ticket to Work program. We'll give you a quick overview of that. How work might impact your Medicaid and Medicare. We'll talk about some Work Incentives that can keep you connected to that program, or either want a little bit longer than you'd expect and who might be able to help you get some of the planning and some of the other services that you need to figure out what's going to happen to your benefits and when.
So, what is Social Security's Ticket to Work program? We have to start out once again by talking about the two different programs that Social Security administers, and they administer the Social Security Disability Insurance program. That is a program that will allow you to buy insurance and buy insured status through paying FICA taxes. The other program is the SSI or Supplemental Security Income program. And this is a needs-based benefits program. It doesn't require a work history, or you may not have enough of a work history, but you could still qualify for SSI. Both programs are very different. They have different Work Incentives and even though some of the Work Incentives sound the same, they work a little bit differently. So, it's really important for you to know which benefit you're receiving. 
How do you do that? You can sign up for a my Social Security account. It's an account that I have. I've had for years now. And this allows you to access your Social Security benefits. It will tell you what benefit you receive; how much they are. In my case I use it for my retirement planning so I will know that if I retire today how much money I'll receive, how much money will my dependents receive, or if I wait a few more years, what will my benefit situation look like. They're really, really great accounts and it's going to help you get services from other folks quicker because they're going to have some valid information that they can use to help you plan. And you can go on to ssa.gov and sign up for a my Social Security account or there will be a link in your web pod to show you how to get into that. 
So why do you choose work? Why do we want you to try work? You know, we recognize that everybody on Social Security disability benefits or SSI based on disability has a severe disability. The definition that Social Security uses is pretty tough. So, you may not be able to go to work full time. It may not be possible for you to earn a living through work because of your disability. But we want you to try. You know, once people understand the free services that are available and the supports that can be provided to you, people often are willing to take that chance because the rewards are going to far outweigh the risks when you have the proper people, the proper return to work team with you. 
What is the Ticket Program? The Ticket Program, first of all, we have to tell you, it is free, and it is voluntary. You can use your Ticket; you don't have to use your Ticket. The services that you get through the Ticket , you know, are in addition to all of the Work Incentives we're going to be talking about today, and you can get career development, you can have resumes built, you can have lots of great services that you would not otherwise get through the normal types of rehabilitation or benefits planning that you would receive. It's available to people who are age 18 through 64 and have been determined to be disabled adults, and you're receiving a benefit from SSDI or SSI. 
How can the Ticket to Work help? As I said, it's a big overlay, it's the big cap on all of the Work Incentives. And Ticket providers, the Employment Networks that we'll talk about a bit, will help you decide if work or self-employment is right for you. You know, help you prepare, do you need education or technical training to do the job that you want to do? You know, are you trying to go back to a job that you had in the past and may need to learn to do that job a bit differently? So, we'll help you get prepared and ready to work, and then help you find paid work opportunities, be they internships while you're in school or if you're out of your school or your training, get you to an employer who is hiring at the moment. 
And you know, even once we get you that job, we're not going to leave you flat. We're going to help you and hang around and provide you with on-the-job supports that you may need until you're comfortable. You know, then you will be hopefully an independent worker who has more money and may be receiving Social Security benefits, may not be. Today's program is directed at that healthcare, and I can assure you for a good long while you will have healthcare. 
So, to learn more about that, you know, the links in the web pod are, what is Social Security's Ticket to Work program and a self-guided tutorial that will take you through everything that you can do with that Ticket to Work. The Ticket to Work Help Line is also available, and they are available to get you to a provider using your Ticket or to talk to you a little bit about the Work Incentives that might be available. The Ticket to Work program offers a toll-free Help Line to answer your questions and support you on your journey to financial independence and that line is open Monday through Friday, 8 am to 8 pm Eastern time. The number is 1-866-968-7842 or if you're using a TTY, it is 1-866-833-2967. Derek, if you can stop and ask a few questions about that first little ditty.

Derek >> This is Derek speaking. Thank you, Ray, and thanks everyone for transitioning through part of our agenda and the overview, the Ticket Program. We're going to take two questions and that will allow us to focus more on the healthcare related content that we know you'll have more challenging questions on too. First, Ray, you mentioned Social Security Disability Insurance and you mentioned Supplemental Security Income. Went through it pretty quickly, if we can revisit those, you know, what they are, but the question is really, I don't know which one or ones I have, how do I find out? So, if you can just revisit those two and how somebody can find out which ones should --

Ray >> Yeah, I can sure do that. As I said, SSDI is Social Security Disability Insurance. We become eligible for that by paying taxes through the FICA system. It will show up as a deduction on your payroll, that's for sure. And after working the sufficient amount of time and earning the sufficient amount of money, you will become insured for both disability and retirement. 
Now, SSI, Supplemental Security Income, is a very different program. It's very much like a federal welfare program that provides benefits to somebody with a disability who may not have had an opportunity to work or has worked and not gained enough of the insured status to qualify for SSDI. The best part of that question, Derek, was how do I find out? And you can find out by registering for that my Social Security account. Once you get that account set up, you'll be able to just click on it and find out exactly what benefit you receive and exactly how much that is. And once again, that's going to help you get a lot of services quicker because we don't have to then wait for the person who's trying to help us to collect that information from Social Security. So that will be your homework tonight. As soon as we get off of this webinar, please go to ssa.gov or use the link in your Web Links pod and register for a my Social Security account.

Derek >> This is Derek. Thank you, Ray, for revisiting that and reinforcing how folks can find out. That Web Links pod number eight, that's a great one. And as Ray and I often talk about, we created those accounts, and you can continue to check them for your benefit status moving forward. All right let's do one more question and then we'll move on. There's a couple of people that haven't worked before and asked questions pretty similar. Can the Ticket Program work for me if I don't have any work experience in the past?

Ray >> And the answer is absolutely. You know, you may be an SSI recipient without a work history, and we are going to get you to work, you know, for the first time. And if you're on SSI and beginning to work, it's important to know that as you work and as you earn, you are going to eventually qualify for SSDI, and you will become insured for that benefit along with a retirement benefit. So, there are many benefits an SSI recipient will receive in addition to the training and the consultation that the Ticket can provide.

Derek >> Excellent. Thank you very much. This is Derek again. Right, let's have you move forward and get into the heart of the content, and I'll be back with you in a little bit for our next question set.

Ray >> Okay, thank you, Derek. So, Medicare and Medicaid coverage in that path to employment. Again, this tends to be people's biggest worry. It's okay if you lose a cash benefit, you know, but -- because we're going to make sure you're earning more than that cash benefit. But it's not okay to lose your healthcare. That can leave us all in a pretty tenuous situation. So, let's talk about this. 
True or false? If I go to work, I will automatically lose my Medicare or Medicaid. The answer is very false. It's as false as you can make it. If you're receiving SSDI or SSI payments in any amount, you're going to keep your healthcare benefits. SSDI brings with it Medicare and SSI folks receive Medicaid. So, you get a dollar of any benefit, any amount at all. You will keep the healthcare program that's associated with that cash. Now, if we go to the next paragraph, if your benefits stop because you have earned too much money, you're going to have more money. So don't worry about those benefits, that cash benefit stopping, but you will remain on your healthcare plan. The only way you're going to lose that is for Social Security to do a review that says you're no longer medically disabled. And that's really, you know, it's a scary thought, but it's really a difficult -- a difficult thing for Social Security to prove. So, the worry shouldn't be as great as most people experience it. We can use Work Incentives to keep your income, your countable income down below certain levels so that you are still receiving benefits for a little bit longer. 
And then we have buy-in programs. If you're a low beneficiary, a low cash beneficiary on the SSDI side, it's possible that we could have the Medicaid agency in your state pay your Medicare premiums. And the Medicaid buy-in that comes along with people who have lost their benefits and exceeded certain limits with earnings is fabulous. It is a game changer, and we're going to talk about that coming up in more detail. 
So, what are these Work Incentives? These Work Incentives make it possible for you to work while still receiving your benefits, both cash and healthcare. They're pretty much able to allow you to work and move along this continuum at your own comfort level and allow you to succeed. You know, some of us are going to be workers long before others may be, but we can make this with planning, take as long as you need to become independent. So how many and what kind of Work Incentives we use will depend upon that type of benefit. Are you receiving SSDI or are you receiving SSI? The Work Incentives are different, you know, as well as other factors that may vary according to your individual circumstances. Everything we're going to do to you with the Ticket to Work and with benefits planning services are based on you. Everything is individualized to accommodate your own situation. 
So, let's talk about Medicare and Work Incentives. This is again the program that comes with Social Security Disability Insurance, and the basic Work Incentives are an extended period of Medicare coverage and Medicare for people with disabilities who work. Now the extended period of Medicare coverage is a good long time. If you notice, most SSDI beneficiaries whose benefits stop because of earnings from work will continue to receive after that Trial Work Period is over, at least 93 months of hospital insurance, which is covered by part A of Medicare, supplemental medical insurance, Part B if you've enrolled in that. And that's the plan that allows you to go for a doctor's visit, you know, and do other things of that nature with your card, and prescription drug coverage, Part D, if you're enrolled. In order to qualify, you must already have Medicare and be working at Substantial Gainful Activity levels. That's what Social Security considers work. This year it's $1550 per month. And that last bullet, you have to continue to be medically disabled. So, if you're determined to be medically improved, you're not going to be eligible for this. But look at 93 months, it's like seven and a quarter years, that's a long time. And during that period of time, we hope your progress continues so that you might get employer covered plans to meet your medical needs or potentially use that Medicaid buy-in. 
Now Medicare for people with disabilities who work, you know, Part B and D have premiums. So, we know that's going to be something that we're responsible for. But after premium-free coverage ends, which is Part A, hospital care, after it ends because of your earnings or your work activity, you can continue to buy that Medicare coverage if you remain medically disabled. So, in order to be eligible for this, you have to be under the age of 65. That used to be the retirement age, for some of us it's a little bit longer now, and it will be 67 in a year or so for everybody. So, we'll have to see what happens when that happens. You continue to have a disability impairment. You know, those medical CDRs are for that purpose. They review your situation and see if you still meet the Social Security guidelines for disability. And your Medicare stopped due to work. You can only continue to pay for your healthcare if your benefits stopped because of work. That's a good thing. That's a good thing. Again, we have to consider, are you receiving an employer plan? How is this going to mix with Medicare? And we'll figure out again with you what's best for your situation.
So, Medicare resources, contact Social Security for information about enrollment periods, or to make an appointment to enroll. Call Social Security at 1-800-772-1213 or 1-800-325-0778 if you're using a TTY. And that will help you get some information and locate your local Social Security office. And you can contact Medicare directly for help paying premiums. And for what type of Medicare you may be receiving, call 1-800-Medicare. Or if you're using a TTY, 1-877-486, 2048, you'll need your card number, your Medicare card number, and prepare to tell that representative what state you're in. That's a very effective phone number. You can talk to a human being fairly quickly and get your information real fast. 
Now, let's switch over to SSI and Medicaid and Work Incentives. Types of Medicaid Work Incentives. These are examples of Work Incentives for people who receive Medicaid. Again, this comes generally with SSI. Medicaid While Working, 1619B, that was a game changer for lots of people. That's a fabulous program. And then the Medicaid buy-in programs. You know, most states have them. There are just a few that don't anymore. And these are also game changers to protect your healthcare while you're working. So, Medicaid While Working, we call it, you know, the number of the statute. The law number is 1619B. So that became the nickname of the program. And a lot of us just refer to it as 1619B. 
If you receive SSI, you may qualify for Medicaid coverage when your payments stop because of earnings. If you are eligible for SSI for at least a month. If you continue to meet the definition of disability established by Social Security, if you still meet all of the other non-disability requirements for SSI, including those income and resource tests. So, it's very important to remember that SSI resource is still $2,000 for an individual, $3,000 for a married couple. You have to keep your resources below that in order to continue with 1619B. Your gross earned income, the amount of money you receive before taxes and other deductions is not enough to replace your SSI payment, Medicaid, or any publicly funded attendant care you receive. That's a big jump, guys, you know, it really is. You need to have a good chunk of change before you can replace all of that. You need Medicaid to work. 
We have to go back to the Ticket to Work Act, the act that started this whole thing. It was the first time Congress said to us, you need healthcare in order to work. So, doesn't that answer your question? You need Medicaid to continue working. And you have gross earnings that are below your state's threshold. Every state spends a little bit of different amount of money on Medicaid for people who live in the community with disabilities. And that's part of the formula. So, every state will have their own threshold. That threshold's amount, what does that mean? It's the amount that measures -- that Social Security uses to measure and decide whether your earnings are high enough to replace SSI and Medicaid benefits. Your individual -- your threshold, I'm sorry, the general threshold amount is based on the amount of earnings that would cause you to lose all of your cash SSI. And the average annual per capita Medicaid expenditure for your state. And we have 57 Medicaid programs for the states and the territories. All of them are different. And if you want to see what your threshold is, there is a link to you. And there's another link in the Web Links pod to see the updated threshold amounts. They change every year. 
Now, what if you have personal care services? What if you have a lot of durable medical equipment? That's all expensive stuff. If you are working and you surpass the state threshold, you could request an individualized threshold. And then they'll base that on the earnings it took to lose your SSI cash plus what Medicaid spent on you last year. And oftentimes these thresholds go way up. If your gross earnings are higher than the threshold amount in your state, you could have an individual threshold if you're using Impaired- related Work Expenses, Blind Work Expenses, a plan to receive -- achieve self-support, publicly funded attendant care, or medical expenses above the state average. And I know of somebody, he's now passed, and this was a while ago, but he was working in the New York State government. His individualized threshold was $102,000 a year. As long as he stayed under $102,000 a year, he had Medicaid. Not so bad. 
And then the buy-in programs, these were also allowed by the Ticket to Work Act. And again, most states have them. We've got a couple of outliers right at the moment. But if your state has a program, you may be able to buy Medicaid if you have a disability and are no longer entitled to free Medicaid because of earnings and work. If this is the case, many states allow you to purchase coverage. You qualify if you meet the definition of disability of the Social Security, so you're still disabled for Social Security purposes, and would be eligible for an SSI payment if not for your earnings. People who are on SSDI may also use this buy-in program. But remember, people on SSDI don't have a resource limit. They would be putting this resource limit on themselves in order to qualify. We still see people doing that all the time. The premiums that are charged are either based upon what your earnings are, or in some states, it's just set at a specific level. And you need to get into your Web Links pod to find a link on that buy-in program. 
Fabulous, fabulous programs that allow us to keep Medicaid. You've got to remember that Medicaid pays for a lot of the supports that you need to work. And your employer coverage might not cover those. So having your employer coverage and the Medicaid buy-in is going to make sure that you can continue to earn. And Medicaid resources. Medicaid While working that 1619B program for more information, use the continued Medicaid eligibility link in your Web pod. And for the Medicaid buy-in program, find your state Medicaid agency in that Web pod. And you can find that out real quick. That's very readily accessible information. 
Now Social Security also puts out a red book. It's available in English and Spanish. And this is a general reference guide about employment-related supports and provisions available for people who receive SSDI and SSI. It includes resources for people who want to work, information about Social Security Work Incentives for both programs, and additional information about healthcare for people with disabilities. And there are resources to help transition aged youth and their efforts to navigate that path towards adult life and become employed rather than an SSI beneficiary. And you can find that by visiting the Red Book. Again, it's available in English and Spanish. And it provides a lot of good information. All right, Derek, we're back to you and your questions.

Derek >> This is Derek rejoining you. Thank you, Ray, for going through the Medicare/Medicaid details, some technical details that are really helpful. And it can also be a lot if it's something that you're listening to for the first time. Appreciate how you went through it. I'm going to jump into the questions so we can continue helping folks get the information they need. We had a question come in that said, I have SSDI. I don't know which one I have, Medicare or Medicaid. And we also have another question that's basically what's the difference between the two. So, can you revisit that and kind of give us the short version of if I have SSDI, I'm getting this healthcare coverage, or if I have SSI, I'm getting that coverage?

Ray >> Okay, let's do that. If you are receiving Social Security disability insurance benefits after a period of time, you will become eligible for Medicare. And that is the one that requires some premiums for Part B and D. Part A is free. So that's what's going to happen most people on SSDI. If you are receiving SSI in most of the states, you're going to get Medicaid automatically. Some of the states still require you to apply separately, and you can do that before you have SSI benefits. So, the two programs are divided in that way. If you receive both benefits, and some people do, you'll have both medical programs. A good quick way to find out which benefit you have. Again, that my Social Security account is going to have some minimal information about your healthcare on it, or you can call that 1-800-Medicare. You would have a Medicare card or your Medicaid card, one or the other. You're going to have a card that tells you what that benefit is as well. So, another good way to find out is to talk to a benefits planner. They can help you navigate those waters to see which plan is going to cover you, and whether or not your employer offered plan might take care of a lot of that stuff. So, there are several ways to find out. But generally speaking, SSDI folks have Medicare, and SSI folks have Medicaid.

Derek >> This is Derek. Thank you, Ray. I think that helps both of those folks, and probably some others that had similar question in mind too. There is a -- our next question is a follow-up, but it dives a little deeper. So, if I earn enough that my SSDI benefits and I can still keep my Medicare coverage, is that correct?

Ray >> Absolutely. Again, we go back into those Work Incentives. Once you begin earning income and you have used your Trial Work Period, you will have Medicare coverage for at least 93 months. And there are possibilities to pay for it if you need it longer than that. But that would come way down the road, so you don't have to worry about that for a good seven years and a couple of months. I think the best thing to do is find out what benefit you're on. Once you get into your Extended Period of Eligibility, you will continue to receive these benefits and focus on your work efforts, because those benefits are going to be with you for at least seven years after that Trial Work Period.

Derek >> This is Derek again. Ray, thank you. That's really helpful when we talk about those 93 months or seven years, it's really impressive that this is available. And this isn't a question that's come in, but it's always one I have. I want to ask you, why do you think that there's misinformation out there about losing Medicare coverage if you have SSDI? That would happen right away when it's such a long period of time after their initial, you know, capacity test of the Trial Work Period, 93 months, but folks don't seem to really know about it.

Ray >> Yeah, people don't know about it. And I think it's been going on ever since I started this, and that was 44 years ago. People were afraid. If I go to work, I'm going to lose my healthcare. And it really was never the case. It was never as long as it is now. We've improved on that bit, but I think it's just the street talking. And the rumors out there, the urban myths that are out there speak really loud. You know, and there are glitches in the system. Sometimes it doesn't work right. That doesn't mean it can't be fixed. What the law is telling us is that you will receive Medicare for at least 93 months. It might be longer, but it won't be any shorter. At least 93 months. And I think we just need more people to experiment with trying to go to work to learn how these programs truly work and get that out onto the street, get the truth out onto the street so that future people who come into these programs and want to try to work aren't listening to myths.

Derek >> This is Derek again. Thank you for reinforcing that and for sharing your experience over a period of time. I think I can encourage people to explore those resources, which I know you'll talk about more in the next segment. We do have another question here that came in. What does medically improved mean and who determines if I'm medically improved? You had that on one of your slides. Cannot be medically improved during that time frame. Can you explain that a little bit further for folks?

Ray >> Sure. What Social Security does when they determine that you are disabled according to their rules is set up a review. Those reviews are set when you get your decision that says you are awarded a benefit. You know, and they're usually either three years, five years, or seven years into the future depending upon the disability. It's a way that we can look at your disability again and see is it still disabling? Medicine changes. Science changes. I usually like when I'm teaching these programs, I usually like to use HIV as a -- excuse me -- as an example. You know, it's really clear. When I started doing this work, there was no HIV. All of a sudden, in the '80s, there's this new disease called HIV. And when you were testing positive, you were going to die. Over time, we haven't gotten rid of HIV, but the medicine has certainly changed so that if you test positive for HIV today, you may be able to take medications and continue to work, you know, and not be devastated by the way this used to happen to people. And what we want to do is determine if you are still disabled. You know, you may not be still disabled. If I have a broken back and I'm going to qualify because it's going to take me two or three years to heal up and get rehabbed and all of that good stuff. The expectation is that I am going to heal up and potentially be able to take my old job back or maybe something with a little wider exertion level. Things change. And we want to make sure that people still receive benefits based on the current medical standards. It is Social Security 's burden to prove that not only do you have medical improvement, but it also relates to your ability to work. And here's another one I give to all of my students and participants in my classes. If I call in sick today with 103 fever, I'm not able to work. If I call in tomorrow with 102 fever, do I have medical improvement? The answer is yes. My fever is down to 102, but it doesn't relate to my ability to work. I'm still pretty sick. So that's the kind of juggling we're doing. And it lets people believe in these programs, that people who aren't entitled aren't getting them and people who are entitled are getting them. And so, Congress is willing to fund it more. Social Security on the SSDI side is using trust fund money to pay those benefits. On SSI side, it's just taxpayers' money that's being used to fund that. So, it maintains honesty and integrity in this program, but it's really nothing to be feared because, as I said, that medical improvement needs to relate to your ability to work, and it's a real tough standard.

Derek >> This is Derek. Thank you, Ray. I appreciate the examples. It helps frame the purpose that's involved behind it, but also some of the examples might help others understand how it might apply to them. Okay, we have about a minute. I'm going to ask you an employer insurance related question that we've had from a couple of folks, and then we'll have you move on. In both questions, one is what happens if I take my employer's insurance and then I stop working. And the other one is if I'm offered employer-sponsored insurance, what happens to my, in this case, it's Medicare, but it could be, I guess, Medicare or Medicaid. So, what happens when employer insurance gets involved? Does it impact continuation of the healthcare coverage, or what happens if I stop working? Do I get access to it again? You got about a minute. Those are some big questions, but what are your thoughts?

Ray >> Yeah, those are pretty big. If your employer offers you a health insurance plan when you start or after your probationary period, or whenever that comes up, it's a good idea to talk. Do you still need Medicare? Does that employer insurance result in what they call creditable coverage? If it does, you don't need to continue to have Medicare, and you can drop out and then in the future drop in without any ramifications. But remember that term of art, creditable coverage. If it's not creditable, you still need to keep your Medicare. But yeah, in the situation where you have Medicaid, you know, Medicaid is a much more expansive program and provides a lot of the very services that people need to stay employed, and Medicaid comes without a cost. So, if you are offered an employer plan, you can keep your Medicaid. Your employer plan probably won't pay for those very supportive services that you need to work. And what would happen in either case is your employer plan would pay first. If you have Medicare, Medicare will look at the rest and pay their share. If you have Medicaid, Medicaid will pick up everything that your employer plan doesn't pay for. So, it's possible to have a mix, but on the Medicare side, be very careful if you decide you don't want to continue with Medicare. That employer plan must be creditable coverage, and a phone call to that insurance company should give you, you know, whether or not that coverage is credible real fast.

Derek >> Right, excellent. Thank you very much for getting into the employer insurance. I think that's helpful for many folks to understand as they contemplate, you know, pathways to work and then pathways for healthcare coverage transition. Speaking of transition, it's that time, we're going to have you proceed into the Employment Team content and then I'll be back with you for one final short Q &A. Thanks, Ray.

Ray >> All right, thanks, Derek. Who can help? You know, we have Employment Teams that can help you. And you can have some of these people on your team. You can have all of the people on your team. It just depends on your, again, individual circumstances. So, who can help you? As you think about going to work, you're probably going to have more questions, more than we were able to cover today.
Remember, connecting with a Ticket Program service provider can help you decide if work is right for you, help you prepare for work, find a paid opportunity, succeed at work, and lets you know what's going to happen before it happens. That's the most important thing. We want to know what's going to happen before it happens. Some Ticket Program service providers can even help you answer questions about how earnings will affect your Medicare and Medicaid. So, we've got lots of people out there who can help, lots of people. And here's your Employment Team. You'll have access to all of these people, and you'll use them according to your needs. 
An Employment Network. And this is somebody who is not a VR agency and can help you on your journey to work by using your Ticket to Work. And they will provide you free services to get you placed. You know, we have the VR agencies that are really big players in this game. VR agencies usually take people who are going to be needing training, who are going to be needing education, who need some serious rehabilitation services. If you don't need that kind of intensive services, an Employment Network can help you get some -- any kind of training that you want, but it can help you get things like resumes started, give you interview practices, point towards employers in your area who might be willing to hire you and have openings at the moment. 
You know, we have the Workforce Employment Network. You might know these as the job -- one stop job centers. That's their old name, but workforce employment services. Great places. Those one-stops really mean it. If you want to start looking for a job, if you want to start trying to develop your own resume or find leads in the community, those workforce centers will set you up with a computer and there will be somebody there to help you. Let's figure out how to get into these sites that have all of that information you need. 
How do you build a resume? So, there's a lot of coached self-help available at one-stops. We talked about those state VR agencies. As a person with a disability determined by Social Security, you are all eligible and it really depends upon the availability of services at the moment you request them. You may have to wait a little bit. 
Work Incentive Planning and Assistance programs. These are the benefits planners. They're funded by Social Security, and they can help people who are working, help people who have a pending job offer, and they're available to youth in transition. Ages 14 through 24 so that we can help those kids get to work rather than get to benefits. 
The Protection and Advocacy for Beneficiaries of Social Security. That was my last job before I joined Cornell. And Protection and Advocacy agencies you can find in the Web Link. You can find all of these in the Web Link pod. But the P and As are usually disability rights with your state name. So, you can even just Google something like that to find them. They're all legal in here. And along the way to work, you might have some problems. You may face an eviction. It's hard to imagine that you're spending a lot of time focused on the return to work if you're about to see your housing come into risk. So, the PABSS could help you with that. If you're applying for jobs, there are a lot of rules, you know, about around what types of questions can be asked. You know, it's not really appropriate for an employer to say, well, you have a disability. How are you going to do this job? That's just wrong. And if you're asked inappropriate questions, the PABSS agency can help you do that. What if you are in need of a reasonable accommodation? The PABSS agency can talk to you about how to ask for that or could help you do that. So, we've got lots of agencies and different people here who can help you get through this return-to-work effort, and help you make it easier for yourself. What we want to do is give you information and give you services and allow you to focus on work, and not worry about all of this other stuff. 
Now, oops, I talked about all of this stuff, didn't I? These, okay, the ENs are private or public organizations that have an agreement with Social Security. They provide services to you free of charge. And as you make progress, Social Security pays the Employment Network for those services. Again, the American Job Centers or one-stop centers are called workforce ENs. How can an EN help you? Lots of ways. Lots of ways. Identify your work goals. They're available just to sit and talk to you. You know, write your resume. Review a resume you have. Prepare for those interviews. Reasonable accommodation requests. And benefits counseling. Lots of the ENs now have benefits counselors on staff. The state VR agencies, again, I like to call them the elephant in the room because they are big, big agencies. They provide a variety of services to help people with disabilities return to work, enter new lines of work, or enter the workforce for the first time. 
So, for all of you SSI folks out there, yes, VR can help you. State VR agencies may offer benefits counseling and may also be able to help you with rehabilitation as well as training and education. How can VR help you? You know, usually, they're working with individuals who need bigger services. People who are going to return to work and need two-year degrees, four-year degrees, some intense technical or vocational training. In some states, you know, well, that's what it says. What I just said. They may also provide career counseling, job placement assistance, as well as counseling about earnings and the effect of earnings on your Social Security benefits. 
You know, the state I came from, Massachusetts, had benefits planners on staff. So, sort of one-stop shopping for a lot of this. And WIPA programs, the Work Incentive Planning Assistance, these are benefits counselors who are funded by Social Security. If you want to learn about how that job, even a part-time job, you know, if you're making $700 a month, what does that do to your SSDI or your SSI? And most importantly, Medicare or Medicaid. As well as other benefits, maybe you have SNAP benefits or food stamps. Earning money is going to impact those benefits. And these planners are going to make sure that you're aware of what happens to your SNAP, what happens to your public housing, if the income is going to increase your rent or not. Help you understand all of these Work Incentives that we've mentioned. There are lots of them. Lots of them, and they're really, really good. Explain the potential benefits of employment and dispel those myths. They will echo a lot of things that I've said that your healthcare will not disappear because you go to work in the morning. It just won't. 
For general information about those Work Incentives, call the Ticket to Work Help Line at 1-866-968-78842 or for TTY users 1-866-833-2967. If you're working at any level, you may be able to get services in your area, and you'll get referred by that Help Line. And the P and A. Again, you can find those in the Web Link pod. We've talked about them. It's the legal support, legal advocacy, helping you resolve any employment-related issues that are going to get in the way of your transition from benefits to financial independence. 
So how do you find a service provider? You know, you can call that Ticket to Help Line. Again, 1-866-968-78842 or TTY users 1-866-833-2967. Monday through Friday, 8 a.m. to 8p.m. Eastern time. Or you can go on the find help page Social Security has. And you can search for an EN, for a WIPA, for a PABSS program by using your zip code. The services you're looking for, what type of language would you like said to you to feel better. Speaking in a Spanish language rather than English. You can fix that up too. Or the provider type. If you're looking for benefits planning, click on benefits planning, so it will limit your search. And choosing a provider. You know, this is your choice. You know, this is absolutely your choice. And you are selecting the people that you want to work with. So, we have a couple of things to help you make that selection. Finding an EN and assigning your Ticket, it's in the Web Links pod and choosing the right EN for you. You know, this could be a really simple thing. If I have blindness and I am trying to find an EN and I find one that has no experience with blindness, maybe that's not the right place for me to go. So, let's search for an EN and pick an EN who has experience working with people with blindness. 
And we always have success stories. And I like these a lot. These are the best part of this. So, we're going to talk about Amy's experience. She grew up with a developmental disability. Amy knew she wanted to work but wasn't sure what her options were. She received services from her state Vocational Rehabilitation agency to find work and later worked with an Employment Network, an EN, that continued to help her develop her career and receive benefits counseling. She learned that she was eligible for Medicaid While Working using that 1619B program, which allowed her to focus on her work goals without worrying about losing healthcare. That's a great story. And just like I've been telling you, focus on your work effort and know you don't have to worry about a lot of these issues. And that takes us to our last set of questions, Derek.

Derek >> This is Derek. Thank you, Ray, for going through the different members of the potential Employment Team. Folks who have a better idea which ones might be right for them. We do have time for a few questions. And we're going to look back at that Employment Team and those providers themselves. One of the questions is, do service providers keep working with me after I get a job?

Ray >> You know, that's a wonderful question. And the truth is, yeah, we do. You know, we don't want to give you a job and then say, bye-bye. Good luck. We want you to succeed. So on the job supports that might end once VR, a state agency, closes your case, we can continue to work with an EN to provide that job coach a little bit longer to make you the most comfortable you can be and the most independent you can be in the future. You know, we're there to provide you with counseling should you need something like that. You might have a bad day at work. You know, something might happen, and you feel you've been treated in a different way because you have a disability. That Employment Network might be there. PABSS will be there. What happens if Mr. Walmart says, you know, it's getting to be the holiday season. Can we get you in here for five hours more each week? What's that going to do to your benefits?

Derek >> Thanks, Ray. This is Derek.

Ray >> Yeah.

Derek >> Let's stick with the ENs. You mentioned the Employment Networks there.

Ray >> Yeah.

Derek >> We have another question specifically about them. This person is concerned about preparing for interviews and how to request reasonable accommodation. I guess they need that to communicate in the interview. Can the Employment Network specifically help in preparing and, you know, how to ask for reasonable accommodations?
Ray >> Absolutely. You know, they will get your resume together. They will give you practice interviews so that you will know what might be expected during that interview. They'll help you prepare questions to ask the employer. Those are very important things, too. If you are going to bring up a reasonable accommodation during the interview, which isn't required, you can do that after they offer you the job, you know, they will help you pose questions about what kind of reasonable accommodations can be made in that job. An Employment Network is a great place for all of those services.

Derek >> This is Derek. Thanks, Ray. Very helpful. What about virtual services? All these Employment Team members, the ENs, the WIPAs, the PABSS', do they provide services virtually for those that want to not actually visit an office?

Ray >> They absolutely. They do. You know, if you have access to FaceTime on a phone, if you have a computer at home, we can get you on to Zoom so that we can meet face to face, or you can just use the phone. I mean, everybody, you know, the pandemic taught us a lot. And one of the things that they taught us is that we can deliver services effectively in a virtual setting.

Derek >> Thanks, Ray. This is Derek again, and time for one more question. And we've had it a couple of times, and we commonly get it because the state Vocational Rehabilitation system, VR agencies, serve so many folks. This question is common. Somebody is out there working with a VR agency now. They want to know; can I also work with the Employment Network that you just described as well?

Ray >> Okay, you can't do that at the same time. You know, usually what happens with the VR agency is they don't assign your Ticket to themselves. They put you in what's called in-use status. And if you are in-use status, once the VR agency closes your case, you can then take your Ticket and assign it to an Employment Network for those on-the-job supports that you may need.

Derek >> Ray, thank you for the answer, but also for joining us today and providing this wealth of information about choosing work and how to retain your Medicare and Medicaid benefits while working. You've been once again an outstanding partner and collaborator and presenter. Thanks.

Ray >> It's always a pleasure, Derek.

Derek >> Okay, folks, it's time now to move to wrap up. But before we do, we have a lot of great resources to share. So, hang in there for just a couple more minutes so you can learn about those. We learned today, obviously, about how work affects disability benefits and healthcare benefits. And we have a lot of options to help you get started. We do encourage you to call the Ticket to Work Help Line. We've mentioned it a couple of times. We'll mention it again now at 1-866-968-7842. Or for TTY users, those are folks who are deaf, hard of hearing, or have a speech disability and use a text telephone to make or receive calls. Reach out to 1-866-833-2967. Of course, you can also visit our website at choosework.ssa.gov. If the content that you liked today was helpful, but you want a refresher, if you go to the Choose Work homepage right now, right on the front of the page, there's a link to one of the factsheets as well. And then you can go to the Wise on Demand to get the recording for a replay in about two weeks' time. And you can always use the find help tool at choosework.ssa.gov/findhelp to access one of those service providers to build the Employment Team of your choice. 
We also have ways that you can connect with us, and we encourage you to do so. You can find us on social media or subscribe to the Choose Work blog. Go to the Choose Work contact page to find us at those locations or get on our email list if you're not on that already. That link is also in the Web Links pod. Next, to get advice and encouragement and read stories about people who achieve financial independence with help from the Ticket to Work program, we do encourage you to consider receiving text messages. You can opt in to receive those messages from the Ticket Program by sending us a text of the word "Ticket," T-I-C-K-E-T. And send that text to 1-571-489-5292. Standard messaging rates may apply depending on your plan. Again, please consider receiving text messages from us at Ticket and recall that those messaging rates could apply. Or you can always send us an email and we encourage you to do so via our email address of support@choosework.ssa.gov. 
And if you liked what we had today, we encourage you to keep joining us. We've had a couple good sessions to start out the year. And in April, on April 24th, we'll have our next WISE webinar entitled “Volunteer your Way to Success in the Workplace.” This will explore how gaining experience through volunteer or customer service could help position you for successful full-time work. You can register online at the Choose Work website or contact us at the Ticket to Work Help Line, those numbers I just provided. 
And importantly, as we go to close, your feedback is important with us. While we appreciate you joining us and working through our technical difficulties, we also appreciate what you think about the content we share and how we do so. So please consider taking our survey. To do so, you can follow the link that will pop up after the webinar, or you can find the survey link in the Web Links pod, or you can visit us at choosework.ssa.gov/surveys/wise. Thank you all for attending today to learn about the Ticket to Work program and how it can affect your Medicaid or Medicare benefits. Please know there are supports and people ready to help, and we encourage you to reach out to begin your journey. This concludes today's webinar.