What Is Supported Employment?

Supported employment is a service that helps people with significant disabilities find, obtain, and maintain competitive integrated employment — meaning real jobs in the community alongside people without disabilities, at or above minimum wage.

Supported employment services include job development (finding job opportunities), job placement, job coaching (on-the-job support from a trained specialist), and long-term follow-along support to help the person maintain employment over time.

How Medicaid Funds Supported Employment

Supported employment is a covered service under many Medicaid HCBS waiver programs, particularly developmental disability waivers and mental health waivers. Medicaid funds job coaching and long-term support services that help people with disabilities succeed in competitive employment.

Vocational rehabilitation (VR) agencies typically fund the initial job placement and training phase, while Medicaid waiver programs fund the ongoing long-term support that VR does not cover.

How Work Affects SSI Benefits

SSI has work incentive provisions that allow recipients to work and earn income while maintaining benefits during a transition period. Key SSI work incentives include:

• Earned Income Exclusion: SSI excludes the first $65/month of earned income plus half of remaining earnings when calculating benefit amounts
• Student Earned Income Exclusion: students under 22 can exclude more earned income
• Plan to Achieve Self-Support (PASS): allows setting aside income or assets for a work goal without affecting SSI eligibility
• Impairment-Related Work Expenses (IRWE): costs related to your disability that are needed to work can be deducted from countable income
• 1619(b): allows Medicaid to continue even after SSI cash payments end due to earnings

Medicaid Buy-In for Working People with Disabilities

Many states offer a Medicaid Buy-In program that allows people with disabilities who work and earn above the standard Medicaid income limit to purchase Medicaid coverage at low or no cost. This program recognizes that people with disabilities often have significant medical expenses that make Medicaid essential even when they are working.

Eligibility rules and premiums vary by state. Contact your state's Medicaid agency to ask about the Medicaid Buy-In or "Working Healthy" program.

Ticket to Work Program

The Social Security Administration's Ticket to Work program provides free employment services to SSI and SSDI recipients ages 18–64 who want to work. Participants can receive vocational rehabilitation, job placement, and ongoing support from Employment Networks — organizations that provide employment services under the program.

Participating in Ticket to Work also provides certain protections against losing benefits while you test your ability to work.

Getting Help

Navigating work incentives and disability benefits is complex. Work Incentive Planning and Assistance (WIPA) programs — funded by Social Security — provide free counseling to SSI and SSDI recipients who want to work. A WIPA counselor can help you understand exactly how working will affect your specific benefits before you start.