- A Specified Low-Income Medicare Beneficiary (SLMB) program helps you pay for Medicare Part B premiums.
- A state’s Medicaid program funds the SLMB program. However, you don’t have to be eligible for Medicaid to enroll in an SLMB.
- To qualify, you must have certain monthly income or resource limitations.
A Specified Low-Income Medicare Beneficiary (SLMB) program is a state-sponsored program that provides financial assistance in paying for Medicare Part B premiums.
To qualify, you or your spouse must have limited income and resources. This program can help make healthcare more affordable if you have difficulty paying your medical bills.
In this article, we’ll cover the details of what an SLMB program does, who may be eligible, how to enroll, and more.
An SLMB program is one of four different Medicare savings programs. The purpose of these programs is help you pay for Medicare costs through state assistance. SLMB is intended to help you pay for Medicare Part B premiums, which can save you more than $1,700 each year.
Even if you qualify for premium-free Part A plan, you usually still need to pay the monthly premium for Medicare Part B. For 2021, the lowest premium amount is $148.50 per month. However, an SLMB program will cover these expenses and lower your overall healthcare costs.
If you or a loved one qualifies for an SLMB program, you will automatically qualify for Extra Help. This additional program helps you pay for prescription drug coverage through Medicare. There are different levels of Extra Help, which can help you pay for coinsurance, deductibles, and premiums for prescription drug costs.
To be eligible for a SLMB program, you must also be eligible for Medicare Part A and meet certain income or resource requirements to qualify.
To be eligible for Medicare Part A, you must be 65 years or older or have a qualifying disability, end stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS). You also must have worked and paid Medicare taxes for at least 40 quarters (about 10 years) to qualify for premium-free Part A.
To participate in the SLMB program, you must have limited income and resources. These financial limits may vary from year to year. For 2021, the income limits are listed in the following chart.
|Individual monthly limit||Married couple monthly limit|
Income limits are slightly higher in Alaska and Hawaii. You should contact your state’s Medicaid office to find out the current limits if you live in these states.
What are resources?
Resources include certain items or money you have in a bank account. Here are some examples of what may be considered resources:
- money in a checking or savings account
Your home, one car, burial plot, furniture, and other household items don’t count as resources. If you have questions about any specific items or accounts that might be counted, contact your state Medicaid office. They can provide a list of specific resources and limits for your state.
Note that if you do qualify for an SLMB, you don’t necessarily qualify for Medicaid benefits. Medicaid requires that you meet separate income limits. Even if you aren’t eligible for Medicaid, you still may be able to get SLMB benefits.
Just try — apply!
If you need assistance or think you might qualify for an SLMB plan, you should apply for the program. Some states have flexibility in their income qualifications (especially in Alaska and Hawaii) and income limits can change every year.
Here are some steps you can take to start the enrollment process for the SLMB program:
- Contact your state’s Medicaid office and ask how to apply. This may involve an appointment in person or submitting an application online or by mail.
- Collect the necessary documents to show your state’s Medicaid office. These typically include your Medicare card, Social Security card, birth certificate or other proof of citizenship, proof of address, proof of income, and a bank statement that outlines your assets.
- Make copies of these key documents in case you need them again.
- Look for a notice in the mail within 45 days that informs you of your application status.
- If Medicaid has denied your application, you have a right to request a hearing to challenge this decision.
- If your application has been approved, Medicaid will start paying for your Medicare Part B premium and will let you know in when coverage will begin.
- Confirm that Social Security no longer takes out this premium out of your monthly check.
Sometimes, it can take time for Medicaid to start paying Medicare directly. You will receive a check for the sum for any months Medicaid was supposed to pay your premium but didn’t.
You will receive a yearly notification that you need to renew or recertify your SLMB benefits. If for some reason you don’t receive a notification, contact your Medicaid office to ensure your benefits don’t run out.
When you qualify for the SLMB program, you will receive a notice from Medicare saying that you qualify for Extra Help. You will then submit this information to your prescription drug (Part D) plan so you can save money on your prescriptions, too.
- The SLMB program can pay for your Medicare Part B premiums.
- You may qualify based on your income or resources. These limits may vary from state to state.
- Contact your state’s Medicaid office to find out how to apply and what types of documentation you need.
- You should hear back within 45 days of applying if you qualify.