What is the Specified Low-Income Medicare Beneficiary Program?
The Specified Low-Income Medicare Beneficiary (SLMB) Program is one of four Medicare Savings Programs. These programs assist individuals who have low income or resources with the costs of Medicare. Medicare Savings Programs are run through each state’s Medicaid program. SLMB covers Medicare Part B premiums.
Who is Eligible for the Specified Low-Income Medicare Beneficiary Program?
Medicare beneficiaries who meet certain income and resource limits are eligible for SLMB. The eligibility limits change a little every year, but around $2000 or less monthly income should be near the eligibility limit, depending on the year, your resident state, whether you’re working, and whether you’re filing as an individual or married couple. Resource limits apply to the monetary value of things like savings accounts, stocks, investment properties, and more.
If you have Medicaid, you will want to apply for the SLMB Program instead of the Qualifying Individual (QI) Program, which offers the same benefits but does not accept Medicaid beneficiaries.
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Extra Help
If you qualify for the SLMB Program, you will also automatically qualify for Extra Help, a program that helps pay for prescription drug coverage. Extra Help may pay your Prescription Drug Plan premium and deductible, as well as set a maximum cost for each prescription, usually between $4-10.
Extra Help is run through the Social Security Administration.
SLMB Example Scenario
You have Medicare Parts A and B, plus a Part D prescription drug plan. You don’t pay a premium for Part A, but you do have premiums for Parts B and D. While on the Specified Low-Income Medicare Beneficiary Program:
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You do not pay a monthly Part B premium
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You do not pay a monthly Part D premium(because of Extra Help)
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You continue to pay your usual deductibles, copay, and coinsurance
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You pay less for your prescriptions, just around $4 for the generic ones and around $10 for the name-brand prescriptions.(because of Extra Help)
What About SLMB and Medicare Advantage Plans?
The Specified Low-Income Medicare Beneficiary Program works with Medicare Advantage (Part C) Plans as well. Because you continue to pay your Part B premium while enrolled in a Part C Plan, that cost will be covered while you are in the SLMB Program. The Extra Help savings on prescription drugs will also carry over to a Medicare Advantage Prescription Drug Plan (MAPD).
If you pay a premium for your Part C Plan, you will continue to pay that while in the SLMB Program, as well as your usual deductibles, coinsurance, and copays, other than the ones related to prescription drug coverage.
How Do I Enroll in the Specified Low-Income Medicare Beneficiary Program?
Contact your state’s Medicaid offices. It’s worth applying for the program even if you’re not sure whether you qualify. Due to differences in eligibility by state—based on your income, savings, properties, and your working situation—calculating your own eligibility can be difficult.
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Frequently Asked Questions
The QI program covers Medicare Part B premiums.
Enrollment Eligibility
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
Special Enrollment Period (SEP)
You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.
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