SLMB is one type of Medicare Savings Program for the "Specified Low - Income Medicare Beneficiary" and, according to the Centers for Medicare and Medicaid Services (CMS), SLMB is defined as: "A Medicaid program that pays for Medicare Part B premiums for individuals who have Medicare Part A, a low monthly income, and limited resources." (source: Medicare.gov).


Question: How do I apply for the SLMB program?

You can contact your local state Medicaid office to enroll into the SLMB program. Here is the Medicare link for finding your state Medicaid office: https://www.medicare.gov/talk-to-someone

Once you contact the state Medicaid office, please explain your situation to a Medicaid representative and ask the representative for assistance.


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).


Qualifying for SLMB status

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 and your state Medicaid program will pay your Medicare Part B premium (and qualify you for the Medicare Part D Extra Help 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.

2023 SLMB income & resource limits:

• Individuals:
  monthly income limit:* $1,478 (up from $1,379 in 2022)
  resource limit: $9,090 (up from $8,400 in 2023)
  
  
• Married couples:
  monthly income limit:* $1,992 (up from $1,851 in 2022)
  resource limit: $13,630 (up from $12,600 in 2022)
  
  

*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.

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

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.

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 (https://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.

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)].”

“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: