Q-3000, Specified Low-Income Medicare Beneficiaries (SLMB) – MC-SLMB

Revision 20-3; Effective September 1, 2020

 

The Specified Low-Income Medicare Beneficiary (SLMB) program is an extension of QMB.

The SLMB Program pays only Medicare Part B premiums for a person who meets the requirements for SLMB. A person receiving Medicaid may also receive SLMB benefits.

To be eligible for SLMB coverage, a person must meet the eligibility criteria for QMB coverage (see Section Q-2000), Qualified Medicare Beneficiaries (QMB) – MC-QMB, except the person must have an income that is greater than 100% but less than 120% of the federal poverty level.

The following may be certified for SLMB if all eligibility criteria are met:

  • persons age 65 or older residing in an institution for mental diseases (IMD);
  • persons of any age residing in state supported living centers;
  • persons residing in intermediate care facilities for individuals with an intellectual disability or related condition (ICF/IID); and
  • persons residing in state supported living centers.

 

Related Policy
Medicare Savings Program Information, Appendix IX
Specified Low-Income Medicare Beneficiaries (SLMB), A-8200
Medicare Savings Program Overview, Q-1000
MSP Resource Limits, Q-1300

 

Q-3100 SLMB Benefits

Revision 09-4; Effective December 1, 2009

 

For SLMB-eligible persons, Medicaid pays only Medicare Part B premiums. However, enrollment in Medicare Part B is not an eligibility criterion.

 

Q-3200 SLMB Income Limits

Revision 20-3; Effective September 1, 2020

 

Monthly income must be more than 100 percent FPL and less than 120 percent FPL.

Use the couple income limit when both spouses are applying for the same program.

The monthly income limits for the SLMB program are:

Time Period Range/Limit
for Individuals
Range/Limit
for Couple
Deeming*
March 1, 2020 to Present $1,064.01 to $1,276 $1,437.01 to $1,724 $448
March 1, 2019 to Feb. 29, 2020 $1,041.01 to $1,249 $1410.01 to $1,691 $442
March 1, 2018 to Feb. 28, 2019 $1,012.01 to $1,214 $1,372.01 to $1,646 $432
March 1, 2017 to Feb. 28, 2018 $1,005.01 to $1,206 $1,354.01 to $1,624 $418
March 1, 2016 to Feb. 28, 2017 $990.01 to $1,188 $1,335.01 to $1,602 $414
March 1, 2015 to Feb. 29, 2016 $981.01 to $1,177 $1,328.01 to $1,593 $416
March 1, 2014 to Feb. 28, 2015 $973.01 to $1,167 $1,311.01 to $1,573 $406
March 1, 2013 to Feb. 28, 2014 $958.01 to $1,149 $1,293.01 to $1,551 $402
March 1, 2012 to Feb. 28, 2013 $931.01 to $1,117 $1,261.01 to $1,513 $396
March 1, 2011 to Feb. 29, 2012 $908.01 to $1,089 $1,226.01 to $1,471 $382

*The deeming amount is the couple limit minus the individual limit.

Note: These amounts do not include the $20 disregard. There must be at least a one cent unmet need for SLMB (MC-SLMB) eligibility.

SLMB uses the same resource limits as QMB and QI.  

 

Related Policy
MSP Resource Limits, Q-1300
Budget Reference Chart, Appendix XXXI

 

Q-3300 Reserved for Future Use

Revision 20-3; Effective September 1, 2020

 

 

 

 

Q-3400 SLMB Medical Effective Date

Revision 13-3; Effective September 1, 2013

 

A person's SLMB eligibility may begin with the month of application. A person with SLMB coverage is eligible for three months prior medical coverage, if all criteria are met.

Do not grant SLMB coverage for QMB applicants whose monthly income is equal to or less than the QMB limit during the three months prior through the QMB eligibility effective date.

SLMB in the three prior months is allowed with ongoing QMB if the individual’s income exceeds the QMB limits in the prior months. This situation occurs when there has been a change in countable ongoing income.

 

Q-3500 SLMB Eligibility and Other Programs

Revision 12-2; Effective June 1, 2012

 

When a Specified Low-Income Medicare Beneficiary (MC-SLMB) recipient becomes eligible for Supplementary Security Income (SSI), the MC-SLMB EDG in TIERS is automatically denied since SLMB is not allowed with SSI.

ME – Pickle, ME – SSI Prior, ME – Disabled Adult Child, and ME – A and D – Emergency cannot be dually eligible for SLMB. Even though ME – Pickle and ME – Disabled Adult Child may meet SLMB eligibility requirements, the Medicare Part B premium is already paid

 

Notes:

  • ME – Early Aged Widow(er) and Disabled Widow(er) cannot be entitled to Medicare; therefore, not eligible for any MSP Program.
  • A person is not eligible for SLMB coverage if the person is:
    • in the custody of penal authorities; or
    • over 20 years of age and under 65 years of age and resides in an institution for mental diseases (IMD).
  • Persons age 65 or older residing in an IMD may be certified for SLMB, if all eligibility criteria are met. Persons of any age residing in state supported living centers may be certified for SLMB, if all eligibility criteria are met. SLMB ongoing and prior coverage is available for ICF/ID and state supported living center residents.
  • SLMB ongoing and prior coverage is allowed with ME – Nursing Facility, which includes individuals on Mason Manor.
  • SLMB ongoing and prior coverage is allowed with ME – Waivers.