Due to the pandemic and the Great Resignation, more people are working from home, providing people with disabilities more opportunities to stay in the workforce. In fact, employment opportunities for working individuals increased significantly during the pandemic. The number of employed workers with disabilities increased, from 35.1% in 2021 to 39% as of December 2022, according to the U.S. Department of Labor (DOL).

Laws such as the Americans with Disabilities Act (ADA) ensure that disabled employees have more access and equal opportunities. The Ticket to Work program supports and encourages disabled workers on the journey to financial independence and self-sufficiency without causing them to lose critical healthcare and other benefits before they’re firmly established in a work environment that can provide benefits. Learn more about this program, how it works, and when it got started.

Key Takeways

  • The Ticket to Work Program helps disabled participants gain independence and paid employment without losing access to critical health care coverage. 
  • Eligible beneficiaries can receive assistance through qualified service providers, which are organizations that offer employment services, vocational rehabilitation services, and other types of support.
  • Participation in the Ticket Program is free and voluntary.
  • Tickets are used with approved employment networks or state vocational rehabilitation agencies.
  • These networks are eligible for payments when the ticket holders they are serving achieve defined goals of work and earnings.

What Is the Ticket to Work Program?

The Ticket to Work program helps people with disabilities return to work. The program was created in 1999 through the Ticket to Work and Work Incentives Improvement Act and signed into law by President Bill Clinton. The program allows workers with disabilities to test their ability to work without losing access to health care on the basis of their disability determination by the Social Security Administration (SSA).

The program’s mission was to address concerns about how few people who receive Social Security disability benefits, whether Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), were able to leave the disability rolls to work and earn a salary. Another issue was that beneficiaries who wanted to work had only one choice: a state vocational rehabilitation agency, which partners with public and private-sector employers to help individuals with disabilities to enter the workforce. Each year, over one mil­lion people with disabilities are served by state VR agencies across the country.

A key provision of Ticket to Work addresses the biggest anxiety of many Social Security disability recipients: losing health care coverage. Program participants can keep their Medicare coverage for at least eight and a half years after returning to work. SSDI beneficiaries who work qualify for premium-free Part A, which covers hospitalizations. Individuals will still be eligible for Medicare Part B but must pay for it themselves unless covered by another third party.

How the Ticket to Work Program Works

Ticket to Work is a free and voluntary program that supports disabled workers aged 18 to 64 with job placement training and other services to aid workplace success. The program’s goal is to help disabled workers achieve financial independence without relying on benefits from the SSA.

For 2023, the maximum SSI federal cash payments for individuals are $914 for individuals and $1,371 for couples. That’s an increase from the 2022 figures of $841 and $1,261, respectively. The average monthly SSDI payment per worker is $1,470 for 2023, up from $1,350 in 2022. The SSDI payment depends on the number of dependents and other factors.

If a disabled employee receives SSI or Social Security they automatically qualify. When eligible workers call the Ticket to Work Help Line at 1-866-968-7842 or 1-866-833-2967 (TTY), they are given a ticket number and a work placement through an employment network or vocational rehabilitation facility.

Participants design a career development plan with a timeline and are held accountable by the SSA to achieve specific goals within a set time frame.

Ticket to Work allows individuals with uninterrupted access to Medicare or Medicaid coverage for as long as they pay the premiums, for up to 93 months after their SSI or SSDI payments have stopped.

Employment for Ticket to Work Participants

Ticket to Work participants can find employment resources and opportunities through an employment network or from a VR agency. These two entities are distinct, such that:

  • An employment network consists of employers, nonprofit organizations (NPOs), government agencies, or combinations of these that deliver or coordinate services for Ticket to Work participants, including training, career advice, job placement, and workplace support.
  • VR agencies are state-level agencies that provide education, skills training, and other aid for people who need greater assistance for work.

Program Incentives

The biggest concern for many individuals with disabilities receiving SSI or SSDI benefits is losing their health insurance. Ticket to Work allows individuals continued access to Medicare or Medicaid coverage for as long as they pay the premiums for up to 93 months after their SSI or SSDI payments have stopped.

It is important to note that many individuals may qualify for cheaper plans through the Affordable Care Act (ACA) and their state’s health insurance marketplace than the cost of most Medicare and supplement plan premiums. If, after a beneficiary’s payments have stopped, they choose an ACA plan and cancel Medicare, they will not be able to get back on Medicare unless they get approved for SSI or SSDI through a process called expedited reinstatement.

In this case, the individuals may also have to sign up for Medicare again during the general enrollment period and pay penalties for the years they did not have Medicare if they cannot qualify for their state to buy them into medicare.

One big part of the Ticket to Work program is that individuals with an open ticket are not flagged for a medical review of their disability solely on the basis of returning to work.

Other Work Incentives

The SSA has several other work incentives to help individuals with disabilities start work or go back to work. They include the trial work period and extended period of eligibility as well as expedited reinstatements.

Note that the trial work period and extended period of eligibility only apply to SSDI benefits—not to SSI benefits. Expedited reinstatements apply to both. If you are on benefits and at any time you worked before now, make sure that you verify whether or not you have used up your trial work period months by calling your local SSA field office.

Trial Work Period

The trial work period is a period of nine months in which a beneficiary receives their full check regardless of how much they earn. The nine months do not have to be consecutive.

A month of earnings counts as a trial work period month if the beneficiary grosses more than $970 a month from W-2 employment or has net earnings from self-employment over $970 in a month or works more than 80 hours in the month of self-employment. Immediately after all nine months of the TWP are up, the beneficiary goes into the extended period of eligibility.

Extended Period of Eligibility

The extended period of eligibility is a period of 36 consecutive months in which a beneficiary is still entitled to their Social Security check each month they earn less than the substantial gainful activity (SGA) limit. They are not entitled to their check if they go over the limit.

The SGA is based on gross earnings on W-2 income and net earnings from self-employment. In 2023, the SGA limits are $1,470 a month for non-blind individuals or $2,460 a month for blind individuals. These amounts are an increase from the 2022 figures of $1,350 and $2,260, respectively.

Once the 36 consecutive months are over or a beneficiary goes over the SGA limit, their check stops entirely. The only way to get it back is through a process called expedited reinstatement.

Expedited Reinstatement

Expedited reinstatement is a term that’s a bit of a misnomer. Individuals who have had their benefits stopped due to work are eligible for a faster decision and provisional payments while they wait for a decision. Ideally, the process is fast, but in reality, beneficiaries can wait months for a decision. Provisional payments are not always processed quickly.

Like everyone, individuals on benefits who have started or returned to work and are concerned about a possible need to go back on benefits should have a robust emergency fund to weather any payment or decision-processing delays.

How Long Can Ticket Holders Receive Health Benefits?

After benefits stop, workers can apply for continued coverage of Medicare. This allows participants to receive healthcare for an additional 93 months, even though they no longer receive cash payments. After this free coverage period, participants can apply for coverage at a reduced rate with Medicare Savings Programs. It may also be possible to receive Medicaid, depending on the state where the ticker holder lives and their income level.

Can a Ticket Holder Work From Home?

Working from home arrangements are permitted under the Ticket to Work program. A number of employment networks specialize in remote work. Working from home can be a good fit for individuals who are housebound, immunocompromised, or who have mobility issues.

Can a Ticket Holder Start a Business?

Yes. Some Ticket to Work Program service providers have experience helping people with disabilities start their own businesses. These service providers can help participants take the first steps to self-employment: thinking about developing business goals, determining target markets, making financial projections, identifying record-keeping requirements, and writing business plans.

The Bottom Line

The Ticket To Work program helps disabled people transition back into the workplace and loosen their reliance on Social Security and Social Security Disability benefits. People who receive disability benefits can make more money, meet new people, and learn new skills when they join the workforce. Over time, participants can replace cash benefits with a paycheck and gain financial independence without immediately losing Medicaid or Medicare health benefits before they are firmly established in their careers.