Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community


What is SLMB or a Specified Low Income Medicare Beneficiary?


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).


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/Contacts/

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. 


2020 SLMB income & resource limits:

  • Individuals:
                  monthly income limit:* $1,296 (up from $1,269 in 2019)
                  resource limit: $7,860 (up from $7,730 in 2019)
  • Married couples:
                  monthly income limit:* $1,744 (up from $1,711 in 2019)
                  resource limit: $11,800  (up from $11,600 in 2019)

*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.


What are the other types of Medicare Savings Programs?



MSP
Income
Limits *
 
Benefit
Qualified Medicare Beneficiary (QMB) Program 100% of FPL
QMB helps pay Medicare Part A premiums, Medicare Part B premiums, deductibles, coinsurance, and co-payments 
Specified Low-Income Medicare Beneficiary (SLMB) Program
100-120% of FPL
SLMB helps pay Medicare Part B premiums
Qualifying Individual (QI) Program 120-135% of FPL QI helps pay Medicare Part B premiums
Qualified Disabled and Working Individuals (QDWI) Program under 200% of FPL  QDWI helps pay Medicare Part A premiums

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

**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)

As reference, Medicare defines SLMB+ as:  “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:
(https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareEnrpts/downloads/Buy-InDefinitions.pdf) and (https://www.medicaid.gov/medicaid/ltss/downloads/integrating-care/cost-sharing-chart.pdf)





Medicare Supplements
fill the gaps in your
Original Medicare
1. Enter Your ZIP Code:
» Medicare Supplement FAQs


Browse FAQ Categories


Check for Savings Using a Drug Discount Card
Prescription Discounts are
easy as 1-2-3
  1. Locate lowest price drug and pharmacy
  2. Show card at pharmacy
  3. Get instant savings!
Your drug discount card is available to you at no cost.




Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.