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What is SLMB or a Specified Low Income Medicare Beneficiary?



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Question: What is SLMB or a Specified Low Income Medicare Beneficiary?

Answer: SLMB is one type of Medicare Savings Program for the "Specified Low - Income Medicare Beneficiary" and, according to the Centers for Medicare and Medicaid (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).

As background, the Medicare Savings Program (MSP) includes four different Medicaid programs (QMB, SLMB, QI, QDWI) available for people with limited financial resources 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.

In addition, 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 that provides financial assistance with your Medicare Part D prescription drug coverage (premiums and drug costs).


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.

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.  For instance,
  • In 2011, the Individual monthly income limit for most states was: $1,109 ($1,491 for Married Couples).  The financial resource level was $6,680 for individuals or $10,020 for married couples.
  • In 2012,  the monthly income limits for most states were less than $1,137 for individuals or $1,533 combined monthly income for married applicants.  The financial resource level (or liquid assets) may not exceed $6,940 for individuals or $10,410 for married couples.
  • In 2015, the monthly income limits for most states were less than $1,197 for individuals or $1,613 combined monthly income for married applicants. The financial resource level (or liquid assets) may not exceed $7,280 for individuals or $10,930 for married couples.
To learn more about qualifying for the SLMB program, you may wish to 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 noted 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

As noted, your SLMB status will also automatically qualify you for the Medicare Part D financial Extra Help program (or Low-Income Subsidy program).

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 (http://www.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

(* 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).

2015 PDP-Finder - Medicare Part D Plan Finder
The 2015 PDP-Finder displays Medicare Part D plan information, including plan premium, deductible, type of gap coverage and if the plan qualifies for the $0 premium for those persons with a low income subsidy (LIS).

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