Specified Low-Income Medicare Beneficiary (SLMB) Program

SLMB pays your Medicare Part B premium but doesn't pay your deductibles or coinsurance amounts. The program follows standard guidelines for income and assets. These are generally based on the SSI limits and may vary by state.

The SLMB program pays Medicare Part B premiums for individuals with income below 120% of the Federal Poverty Guideline. This state-sponsored program does not pay for other Medicare benefits, such as deductibles and coinsurance. SLMB eligibility can also open up opportunities to enroll in a Medicare Advantage plan, which could provide additional benefits like dental and vision care.

Eligibility

To be eligible for SLMB, you must meet your state Medicaid program’s general and financial requirements. This includes being a US citizen or qualified alien, and meeting the age requirement of 65 years, or having a disability such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). You must also be enrolled in Medicare Part B insurance. You can find out more about these requirements by contacting your state’s Medicaid office.

You may also qualify for SLMB if you are dually eligible for a MA-only managed care plan and your income is low enough. Generally, your countable income must be below the SLMB standard plus any applicable spenddown amounts. However, this varies by state. In some cases, your countable income is based on your household size rather than your individual income. You must also have assets below certain limits, which vary by state.

Does SLMB Pay Part B Premiums

Does SLMB Pay Part B Premiums?

SLMB pays Medicare Part B premiums for people with incomes above the QMB standard but below 135% of FPL. It does not pay Medicare copayments or deductibles, nor cover the cost of Medicare Advantage special needs plans (D-SNP) and Medicare Part D prescription drug plans. SLMB eligibility also automatically qualifies you for the Extra Help program that helps with Medicare Part D plan premiums and lowers or eliminates copayments and coverage gaps.

Specified Low-Income Medicare Beneficiary (SLMB) Program helps pay for: Part B premiums (You must have both Part A and Part B to qualify.)

What is the Difference Between QMB and SLMB?

The SLMB Program and the Qualified Individual (QI) Program are state programs that help pay for Medicare Part B premiums for individuals who have limited income and assets. These programs are different from the QMB Program because they only cover the cost of Part B premiums and don’t pay for Medicare deductibles or copayments.

The QMB Program pays the monthly Medicare Part B premium for people who meet the program’s income and asset limits. This helps offset the cost of Medicare-covered services, which can significantly save some Medicare beneficiaries. People who qualify for the QMB program are also excused from paying the Medicare deductibles and copayments that are associated with certain Medicare-covered services.

If you qualify for the SLMB Program or QI Program, you will automatically be enrolled in Medicare Part D’s Extra Help program, which can help you pay your prescription drug plan premium and reduce your drug copayments. This is because you are considered dual-eligible for both SLMB and Medicaid, which means that your SLMB and QI benefits will work together.

What is the Income Limit for SLMB

What is the Income Limit for SLMB?

SLMB has income limits based on the federal poverty guidelines (FPG). These limits apply to both individuals and couples. When applying for SLMB, the individual or couple’s total monthly income must be less than or equal to the SLMB income limit. The SLMB income limit for couples is the total of the individual’s income minus $20. The deemed income of an ineligible spouse is also included in the total monthly income.

Unlike QMB, SLMB does not have spenddown provisions. However, if an individual’s countable resources are below the SLMB standard, they may be eligible for SLMB Plus. Countable assets include personal property, cash, savings accounts, stocks and bonds, an interest-bearing checking account, one car, a burial plot, and up to $1,500 worth of funeral expenses.

The SLMB program pays the Medicare Part B premium for individuals with incomes below 120% of the FPL. The program also pays for the Medicare deductible and coinsurance. SLMB is one of four different Medicare Savings Programs. To be eligible, you must meet certain requirements, including being enrolled in Medicare Part B and meeting the income and asset limits.

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