Understanding the SLMB Medicare Savings Program: A Guide to Financial Assistance

The SLMB (Specified Low-Income Medicare Beneficiary) program helps pay Medicare Part B premiums, while the SLMB Plus program extends additional Medicaid benefits. Both programs require applicants to meet specific income and resource thresholds.

SLMB is a state-run initiative designed to provide financial relief for Medicare Part B premiums to eligible individuals with limited income and assets. This assistance can make healthcare more affordable for those struggling with medical expenses.

What Benefits Does the SLMB Program Offer?

The SLMB program reduces your Medicare-related costs by covering Part B premiums, which are essential for outpatient services. It is one of four Medicare Savings Programs (MSPs) available to low-income beneficiaries.

Even if you qualify for premium-free Medicare Part A, you typically must pay a monthly premium for Part B, which in 2025 starts at $185. SLMB helps by covering this premium, easing your financial burden.

Qualifying for SLMB Plus not only covers your Part B premium but also grants Medicaid benefits, providing broader healthcare support. Additionally, enrollment in any SLMB program automatically qualifies you for Medicare Extra Help, which assists with prescription drug costs including premiums, deductibles, and coinsurance.

Who Can Qualify for SLMB?

Eligibility for SLMB requires you to be enrolled in Medicare Part A and meet certain income and resource limits. Medicare Part A eligibility typically applies to those aged 65 or older, or individuals with qualifying disabilities, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS), with a work history of at least 40 quarters paying Medicare taxes.

For 2025, the financial limits for SLMB eligibility are:

Income limits may be higher in Alaska and Hawaii, so contacting your state Medicaid office is recommended for precise figures.

What Counts as Resources?

Resources include cash, bank accounts, stocks, and bonds. However, your primary residence, car, burial plots, and household items are generally excluded. For clarity on specific assets, consult your state Medicaid office.

Note that qualifying for SLMB does not automatically mean eligibility for Medicaid benefits unless you meet additional criteria for SLMB Plus.

Don’t hesitate to apply! Income limits and eligibility rules can vary and change annually, so it’s beneficial to submit an application if you think you qualify.

How to Apply for the SLMB Program

To enroll in SLMB, follow these steps:

• Reach out to your state Medicaid office to learn about the application process, which may include in-person appointments or online/mail submissions.
• Gather necessary documents such as your Medicare card, Social Security card, proof of citizenship, residence, income, and asset statements.
• Make copies of all documents for your records.
• Wait for a response, typically within 45 days, regarding your application status.
• If denied, you can request a hearing to appeal the decision.
• If approved, Medicaid will begin paying your Medicare Part B premiums and notify you about the coverage start date.
• Verify that your Social Security benefits no longer deduct Part B premiums.

Sometimes Medicaid payments to Medicare may be delayed. In such cases, you will receive reimbursement for premiums paid during the interim.

Remember to renew or recertify your SLMB benefits annually to maintain coverage. If you don’t receive a renewal notice, contact your Medicaid office promptly.

Upon qualifying for SLMB, you’ll also receive notification about Extra Help, allowing you to save on prescription drug costs through your Medicare Part D plan.

Common Questions About SLMB

What is SLMB Plus?

SLMB Plus extends beyond Part B premium coverage by providing full Medicaid benefits to eligible individuals with incomes generally between 100% and 120% of the Federal Poverty Level.

What is the QMB Medicaid Program?

The Qualified Medicare Beneficiary (QMB) program is another Medicare Savings Program that assists low-income individuals by covering Medicare premiums, deductibles, coinsurance, and copayments for Parts A and B.

Which Program is More Beneficial: SLMB or QMB?

While SLMB covers only Part B premiums and is for those with slightly higher incomes, the QMB program offers more comprehensive financial assistance, including coverage for deductibles and copays. Both programs significantly reduce out-of-pocket healthcare costs.

Learn more about eligibility and benefits of the Qualified Medicare Beneficiary program to determine the best option for you.

Summary

The SLMB program provides crucial support by covering Medicare Part B premiums, helping make healthcare more affordable for eligible low-income beneficiaries.

Eligibility depends on income and resource limits, which vary by state. Contact your state Medicaid office to learn about application procedures and required documents.

Expect a decision within 45 days after applying. If approved, your Medicare Part B premiums will be paid directly, and you’ll also qualify for Extra Help with prescription drug costs.

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