SLMB or "Specified Low-Income Medicare Beneficiary" is a person qualifying for a type of Medicare Savings Program (MSP) designed for people with limited monthly income and resources (assets).

Qualifying for the Specified Low-Income Medicare Beneficiary Medicare Savings Program means that your Medicare Part B premiums will be paid by your state Medicaid program (and qualify you for the Medicare Part D Extra Help program that will help paying your drug plan premiums, deductible, and prescription costs).

In addition, your state Medicaid program may provide additional SLMB benefits - and you can contact a local Medicaid office for more details.  (You can use the following link to find your state Medicaid office: https://www.medicare.gov/Contacts/).

Question: How do I apply for the SLMB program?

You can contact your local state Medicaid office to learn more about the SLMB program.  A state Medicaid representative can then explain about qualifying and enrolling into the program.

More about qualifying for SLMB status

In general, if you have countable financial resources (or assets) at or below two-times the standard allowed by the SSI program and an annual income not higher than 120% of the Federal Poverty Level (FPL), you may be qualified for your state's SLMB program.  Please note that some states have more flexible or lenient income and assets levels for qualifying for their Medicaid programs - and, financial limits are slightly higher in the states of Alaska and Hawaii.

Please also note, the financial resource requirements and the Federal Poverty Level can change each year, so even if you did not qualify for the SLMB program last year, you may qualify this year.

2024 SLMB income & resource limits:

• Individuals:
  monthly income limit:* $1,526 (up from $1,478 in 2023)
  resource limit: $9,430 (up from $9,090 in 2023)
  
  
• Married couples:
  monthly income limit:* $2,064 (up from $1,992 in 2023)
  resource limit: $14,130 (up from $13,630 in 2023)
  

*As noted, financial limits are slightly higher in Alaska and Hawaii.
If you have income from working, you may qualify for benefits even if your income is higher than the limits listed.

A note on what is counted toward your financial resources or assets

As described by Medicare:  Your countable financial resources (or assets) include any money in a checking or savings account, stocks, mutual funds, and bonds.  However, when you count your financial resources, you do not include:

• your primary home,
• one car,
• a burial plot,
• furniture, or other household and personal items, and
• up to $1,500 for burial expenses if you have put that money aside.

Again, to learn more about qualifying for the SLMB program in your state, please contact your local Medicaid office and speak with a Medicaid representative or you can telephone the Social Security Administration at 1-800-772-1213 (TTY users should call 1-800-325-0778).

More about SLMB and Medicare Part D Extra Help

If you are a Medicare beneficiary who qualifies for the QMB, SLMB, or QI program, you will automatically qualify for the Medicare Part D Extra Help program (or Low-Income Subsidy).  The Medicare Part D Extra Help program will help you pay your Medicare Part D prescription drug plan premiums, provide lower co-payments on your medications, and remove the Donut Hole or Coverage Gap from your prescription drug coverage.

You can click here (q1medicare.com/PartD-Financial-Assistance-by-Medicaid.php) to read more about the Medicare Part D Extra Help program and what qualifies for Income and financial resources.

As background . . .

Medicare Savings Programs (MSP) include four different Medicaid programs (QMB, SLMB, QI, QDWI) available for people with limited financial resources who are eligible for both Medicare and Medicaid (dual eligible).  And, depending on your income and assets, Medicare Savings Programs may pay your monthly Medicare Part A premiums (for in-patient and hospital coverage), as well as Medicare Part B (out-patient and medical coverage) premiums, deductibles, coinsurance, and co-payments.  For more information about the different Medicaid programs (including SLMB), you can also telephone a Social Security Administration representative at 1-800-772-1213 (TTY users should call 1-800-325-0778).

Question: What are the other types of Medicare Savings Programs?


(You can read more about Medicare Savings Programs in our FAQ: Q1FAQ.com/184)

**The FPL is the Federal Poverty Level and some portions of your income may not count toward reaching the income level - for instance, the first $20 of your monthly income.


SLMB Plus (SLMB+) and Medicare Advantage Special Needs Plans for Dual Eligibles (D-SNPS)

In short, SLMB plus or “SLMB+” is a designation for people who meet the SLMB financial standards and also are eligible for full Medicaid benefits in their state.

For SLMB+ beneficiaries, Medicaid pays their Medicare Part B premium and provides full Medicaid benefits for SLMB+ beneficiaries (Member’s Medicare Part B cost-share is paid by Medicaid only when service is covered by both Medicare and Medicaid).

The SLMB+ designation may be a minimum eligibility requirement for people who wish to join a Medicare Advantage Special Needs Plan that is designed especially for people eligible for both Medicare and Medicaid (D-SNPs)

“SLMBs with full Medicaid (SLMB Plus) - These individuals are entitled to Medicare Part A, have income of greater than 100% FPL, but less than 120% FPL and resources that do not in exceed twice the limit for SSI eligibility, and are eligible for full Medicaid benefits. Medicaid pays their Medicare Part B premiums and provides full Medicaid benefits. [Federal financial participation (FFP) equals the Federal medical assistance percentage (FMAP)].”

Medicaid adds to this definition with:

“A “SLMB Plus” is an individual who meets the standards for SLMB eligibility, but who also meets the financial criteria for full Medicaid coverage.  Such individuals are entitled to payment of Medicare Part B premiums, as well as all benefits available under the State Plan to a fully eligible Medicaid recipient. These individuals often qualify for Medicaid by meeting the Medically Needy standards, or though spending down excess income to the Medically Needy level.”

As reference see: