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."
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/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
) 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
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
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.
2021 SLMB income & resource limits:
monthly income limit:* $1,308 (up from $1,296 in 2020)
resource limit: $7,970 (up from $7,860 in 2020)
monthly income limit:* $1,762 (up from $1,744 in 2020)
resource limit: $11,960 (up from $11,800 in 2020)
*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
- 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: 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)
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
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)