The Specified Low Income Medicare Beneficiary Program

Specified Low Income Medicare Beneficiary

People who meet income and resources guidelines may qualify for help paying their Medicare costs.

In some cases, you can get help from your state with paying your Medicare premiums. If you meet certain conditions, some programs may even pay Part A and Part B deductibles, co-insurance, and co-payments. These programs are called Medicare Savings Programs (MSPs).

MSPs, also known as Medicare Buy-In programs or Medicare Premium Payment Programs, help pay Medicare costs if you have limited income and savings and meet specific eligibility requirements. These federally funded programs are administered by states and help those who qualify pay for some or all of their Medicare costs.

There are four kinds of MSPs, including the Specified Low Income Medicare Beneficiary (SLMB) program. Read on to learn more about this program, including who is eligible and how to enroll, as well as information about other MSPs you may qualify for.

What is the SLMB program?

The Specified Low Income Medicare Beneficiary program is a federally funded state program that helps pay Part B premiums for those who have limited income and resources. This could save you nearly $1,800 per year because the 2023 Part B premium is $164.90 per month.

The SLMB program covers this expense and can also help lower your overall healthcare costs. If you qualify for an SLMB program you automatically qualify for Extra Help, which helps you pay for prescription drug coverage through Medicare. This could include co-insurance, deductibles, and premiums for prescription drug costs.

Who is eligible for the SLMB program?

To qualify for an SLMB program, you must:

  • Be eligible for Medicare Part A
  • Have limited income and resources

Financial limits can vary from year to year. In 2021, to participate in the SLMB program you must meet the following requirements:

Individual Monthly Limit

Married Couple Monthly Limit

Income Limit

$1,379

$1,851

Resource Limit

$8,400

$12,600

Income limits are slightly higher in certain states, so if you live in Alaska or Hawaii, contact your state's Medicaid office to learn your state's limits.

Resources include items such as stocks and bonds or money in a checking or savings account. Resources that don't count toward the limit include:

  • Your primary home
  • A vehicle
  • A burial plot
  • Furniture and other household or personal items
  • Up to $1,500 for burial expenses (if you've put that money aside)

Your state Medicaid office can provide a specific list of resources and limits for your state if you have questions.

In summary, you may qualify if:

  • You have or are eligible for Medicare Part A
  • Your income for 2021 is at or below the income limits listed above
  • You have limited resources, below those listed above

To learn more, call your State Medicaid Program.

How to enroll in the SLMB program

If you qualify and would like to start the enrollment process, you have a few steps to take including:

Schedule an in-person appointment with your state's Medicaid office OR submit an application online or by mail

Gather the necessary documents, such as

  • Medicaid card
  • Social Security card
  • Birth certificate (or other proof of citizenship)
  • Proof of address
  • Proof of income
  • Bank statement

Once you apply, you should receive a notice in the mail within 45 days that informs you of your application status. If you're denied, you can request a hearing to challenge that decision.

If your application is approved, Medicaid will start paying your Part B premium. Your notice will let you know when coverage begins.

Once approved and your coverage kicks in, make sure the premium is no longer deducted from your Social Security check.

Then once you qualify, you'll also receive a notice that you qualify for Extra Help. You can submit this information to your Part D prescription drug plan to help you save on your prescriptions.

Other Medicare Savings Programs

In addition to the SLMB program, there are three other MSPs you could qualify for, including:

  • Qualified Medicare Beneficiary (QMB) Program: This program helps pay for both Part A and Part B premiums, as well as Part B deductibles, co-insurance, and co-payments.

Individual Monthly Limit

Married Couple Monthly Limit

Income Limit

$1,153

$1,546

Resource Limit

$8,400

$12,600

With this plan, providers cannot bill you for services and items Medicare covers except for outpatient prescription drugs.

  • Qualified Individual (QI) Program: This program pays Part B premiums, but you must apply every year for QI benefits. These applications are granted on a first-come, first-served basis with priority given to those who had benefits the previous year.

Individual Monthly Limit

Married Couple Monthly Limit

Income Limit

$1,549

$2,080

Resource Limit

$8,400

$12,600

Qualified Disabled and Working Individuals (QDWI) Program: This program helps pay the Part A premium if

  • You're a working, disabled person under age 65
  • You lost your Social Security disability benefits and premium-free Part A because you returned to work
  • You aren't getting medical assistance from your state
  • You meet the income and resource limits

Individual Monthly Limit

Married Couple Monthly Limit

Income Limit

$4,615

$6,189

Resource Limit

$4,000

$6,000

Are you ready to join a Medicare plan?

Our licensed insurance agents can help you understand your Medicare plan options. Just call us toll-free to get started. You can also use our Find a Plan tool to review Medicare Advantage, Part D, and Medigap plans in your area. Just enter your zip code to get started.

Additional Resources

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