The Specified Low-Income Medicare Beneficiary (SLMB) program helps people with Medicare Part A pay for their Medicare Part B monthly premiums or out-of-pocket costs.
A person is eligible for SLMB if their income and resources fall below certain limits. While most states have the same income and resource criteria, there are a few exceptions.
This article discusses the eligibility requirements of the SLMB program. It then discusses the other three programs that help people pay their Medicare costs, lists the states with different income and resource limits, and describes how to apply for a program.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
The SLMB is a state rather than a federal program. It aims to help someone pay their Medicare Part B premiums if they meet certain conditions.
One requirement is enrollment in Part A.
The other requirements involve a person’s income and resources. Income limits in most states are as follows: An individual’s monthly income must be under $1,526, or a married couple’s monthly income must be under $2,064.
In addition, a person must have limited countable resources, which include:
- stocks
- bonds
- money in a savings or checking account
Countable resources do not include:
- home
- car
- burial plot
- life insurance with a value of less than $1,500
- furniture
- other household items
Some states may exclude additional assets. The resource limits in most states require that an individual’s resources fall under $9,430 or a married couple’s resources fall under $14,130.
This benefit can save individuals hundreds of dollars each year by covering the full Medicare Part B premium, which significantly reduces their overall healthcare costs.
Some people with Original Medicare buy Medicare supplement insurance called Medigap to help with uncovered costs. However, not everyone can afford Medigap premiums.
To help people with a low income to pay Medicare costs, states offer the SLMB program plus three additional Medicare savings programs (MSPs):
- Qualified Medicare Beneficiary (QMB) program, which helps with Part A and Part B premiums, as well as deductibles, copayments, coinsurance, and prescription drugs
- Qualified Individual (QI) program, which helps with Part B premiums
- Qualified Disabled and Working Individuals (QDWI) programs, which help with Part A premiums
Limits
The chart below shows the income and resource limits of each of the three programs, plus SLMB.
| Individual income limits | Married couple income limits | Individual resource limits | Married couple income limits | |
|---|---|---|---|---|
| QMB | $1,275 | $1,724 | $9,430 | $14,130 |
| QI | $1,715 | $2,320 | $9,430 | $14,130 |
| QDWI | $5,105 | $6,899 | $4,000 | $6,000 |
| SLMB | $1,526 | $2,064 | $9,430 | $14,130 |
Qualified Medicare Beneficiary program
The QMB program helps pay for Medicare Part A and Part B premiums. In addition, it does not permit Medicare to bill a person for deductibles, copayments, and coinsurance if the expenses are associated with covered services and items.
Also, in 2024, the program does not allow pharmacies to charge more than $11.20 for a prescription that Part D covers. Part D is the Medicare plan that provides prescription drug coverage.
The income limits in most states require that an individual’s monthly income fall under $1,275 or a married couple’s monthly income fall under $1,724.
The resource limits in most states require that an individual’s resources fall under $9,430 or a married couple’s resources fall under $14,130.
Qualified Individual program
The QI program helps people pay Medicare Part B premiums if they have Medicare Part A, and their income and resources meet the requirements. A person must apply every year for the benefits. When approving applications, Medicare prioritizes someone who had QI the previous year.
The income limits in most states require that an individual’s monthly income fall under $1,715 or a married couple’s monthly income fall under $2,320.
The resource limits in most states require that an individual’s resources fall under $9,430 or a married couple’s resources fall under $14,130.
Qualified Disabled and Working Individuals program
The QDWI program helps pay Medicare Part A monthly premiums. Someone may qualify if any of the following conditions apply:
- they have a disability
- they are working
- they lost their Social Security disability benefits and Medicare premium-free Part A because they returned to work
The income limits in most states require that an individual’s monthly income fall under $5,105 or a married couple’s monthly income fall under $6,899.
The resource limits in most states require that an individual’s resources fall under $4,000 or a married couple’s resources fall under $6,000.
Some states vary the income and resource limits.
States with higher income limits include Alaska, Hawaii, and Maine.
States without resource limits include Alabama, Arizona, Mississippi, Connecticut, New York, Delaware, DC, and Vermont.
To apply for any MSPs, a person can visit this website and click on their state.
Other than having income and resources that fall under the limits of the programs, having Medicare Part A is the eligibility requirement for all four programs. A person enrolled in a Medicare Advantage plan is still eligible for MSPs, as long as they meet the income, resource, and Part A requirements.
If someone’s income seems higher than the limits, they should still apply because not all states consider the following items in their calculations:
- the first $65 of monthly wages
- half of monthly wages after deducting the $65
- food stamps
Also, according to the Kaiser Family Foundation, most states, with the exception of Connecticut, don’t count the first $20 of a person’s monthly income when determining eligibility for MSPs.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
The SLMP program helps people with low incomes pay Medicare Part B monthly premiums. There are three other state MSPs that help individuals with Medicare costs.
The income requirements for each program are generally consistent across the country. However, some states have higher income limits, and some states do not have resource limits.
With this in mind, a person may wish to apply to the programs even if they believe their income and resources are too high to qualify.
