Revision 21-2; Effective June 1, 2021
The Specified Low-Income Medicare Beneficiary (SLMB) program is an extension of QMB.
A person receiving Medicaid may also receive SLMB.
Note: ME-Pickle and ME-Disabled Adult Child recipients cannot be dually eligible for SLMB as the Medicare Part B premium is already paid.
To be eligible for SLMB, a person must meet the eligibility criteria for QMB (see Section Q-2000), 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:
- people 65 or older residing in an institution for mental diseases (IMD);
- people of any age residing in state supported living centers;
- people residing in intermediate care facilities for individuals with an intellectual disability or related condition (ICF/IID); and
- people residing in state supported living centers.
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 21-2; Effective June 1, 2021
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.
|March 1, 2021 to Present||$1,074.01 to $1,288||$1,452.01 to $1,742||$454|
|March 1, 2020 to Feb. 28, 2021||$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.
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
- 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.