What Is the Specified Low-Income Medicare Beneficiary (SLMB) Program?

Have you heard of Medicare Savings Programs (MSPs)? If you’re a Medicare beneficiary living on a low or fixed income, an MSP could help cover some of your out-of-pocket health care costs. There are four state-sponsored MSPs, including the Specified Low-Income Medicare Beneficiary (SLMB) program. Learn more about this program and see if you may qualify for help.

What is the Specified Low-Income Beneficiary program?

Under the SLMB program, Medicaid covers the Medicare Part B (Medical Insurance) premium for certain Medicare beneficiaries who have limited income and assets. The Part B premium is a fixed amount you pay for coverage each month. This amount is typically deducted automatically from your Social Security check.

While SLMB will cover your Part B premium if you qualify, it won’t affect your Part A premium. But most people do not pay a monthly premium for Part A anyway. If you have premium-free Part A and are enrolled in SLMB, your total monthly premium for Original Medicare is $0.

What does Specified Low-Income Medicare Beneficiary coverage mean?

Simply put, being enrolled in the SLMB program saves you money. Since you don’t have to pay the Part B monthly premium, you can save $1,978.80 annually in 2023. Having extra money in your Social Security check each month can make life a little easier. You’ll have more to spend on healthy groceries, heating and cooling bills, rent or mortgage, and other costs of living.

The SLMB program allows for retroactive reimbursement for your Part B premiums. That means you can get money back for any Part B premiums you paid (through your Social Security check) up to three months before your SLMB enrollment effective date. You can even be reimbursed for premiums paid the calendar year before the year your SLMB coverage became effective—as long as you met SLMB eligibility guidelines during that time.

Having SLMB also means you qualify for the Medicare Part D Low Income Subsidy (LIS) program. Also known as Extra Help, this benefit has an estimated value of $5,300 yearly for each enrollee. With Extra Help, you may not have to pay any premiums or deductibles for your Part D prescription drug plan. Also, your out-of-pocket cost for each covered drug is limited to $10.35 in 2023. Extra Help gives you access to a quarterly Special Enrollment Period during which you can join or switch drug plans. It also prevents you from having to pay an enrollment penalty if you enroll late in a Part D plan.

If you’re approved for SLMB, your enrollment in Extra Help is automatic and you don’t need to fill out a separate application.

What is SLMB Plus?

If you meet the income limits for SLMB but also qualify for full Medicaid benefits, you are considered dual-eligible. This status qualifies you for a program called SLMB Plus (or SLMB+).

As an SLMB Plus beneficiary, you’ll receive benefits from both the SLMB program and your state Medicaid program. This dual coverage could give you access to important health care services not covered by Medicare, such as vision, hearing, and dental care. Your SLMB Plus beneficiary status may also qualify you to join a Medicare Advantage Special Needs Plan (D-SNP). A D-SNP is a type of Medicare Advantage plan for people who are dual-eligible.

What is the income limit for SLMB?

To be enrolled in SLMB, you must qualify for or be enrolled in both Medicare Part A and Part B. Also, your income and assets cannot be above certain limits set by the state where you live. Most U.S. states use the general guidelines below, but some may set higher income limits or waive the asset limits altogether. These limits are based on the Federal Poverty Guidelines (FPG) and change every year. New limits are released each January.

Note: Your state Medicaid agency may not start to use the current year's guidelines until March or April, after the Centers for Medicare & Medicaid Services have formally published these figures.

What are the general SLMB income limits for 2023?

A $20 general income disregard applies to all of the MSPs in every state, meaning that the first $20 of your monthly income does not count toward the income limit. Supplemental Nutrition Assistance Program (SNAP, or food stamps) monthly benefits are also excluded if you receive those.

Countable assets (or resources) include:

• Money in your checking and savings accounts
• Stocks
• Bonds

They do not include:

• Your primary home
• One vehicle
• Furniture and other household/personal items
• Burial plots and up to $1,500 in burial expenses per person

Think you make too much money to meet your state’s SLMB guidelines? You may still qualify for one of the four MSPs, since certain parts of your income and assets may not be counted toward the limits. It costs nothing to apply to the programs to see if you’re eligible for assistance.

How do I apply for the SLMB program?

You will be enrolled in the Medicare Savings Program for which you qualify based on your income and assets (you won’t be able to choose the program you prefer). Since all states have their own requirements and application process, it’s important to learn the specific MSP guidelines for your state.

Your State Health Insurance Assistance Program (SHIP) can be a helpful resource if you want to know whether you qualify for SLMB or another MSP. Call 1-877-839-2675 or visit the SHIP website to find your local program. They can help you determine your eligibility and get started with filing an application.

It’s also a good idea to visit BenefitsCheckUp®, our free online benefits finder tool. Enter your ZIP code to find out if you can save money on food, utilities, health insurance, housing, and more. This tool can also tell you if you qualify for the Specified Low-Income Medicare Beneficiary (SLMB) program or any of the other MSPs.