Learn About the SLMB Program and Options

Understanding the SLMB Program: The Basics

The Specified Low-Income Medicare Beneficiary (SLMB) program is a state-run Medicaid program that helps people with Medicare pay certain costs. The program pays Medicare Part B premiums for individuals who meet income and resource limits set by their state. Part B covers doctor visits, outpatient services, and other medical care not included in Medicare Part A (hospital insurance).

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As of 2024, the federal poverty level for an individual is about $14,580 per year, and the SLMB income limit is typically set at 120% of the federal poverty level, which equals roughly $17,500 per year for a single person. States may set their own limits within federal guidelines, so the exact income threshold varies by location. Resource limits also apply—most states allow individuals to have up to $8,820 in countable resources, though this amount changes yearly.

The SLMB program exists because Medicare Part B premiums can be expensive for people living on fixed incomes. In 2024, the standard Part B premium is $174.70 per month for most beneficiaries. For someone living on a modest Social Security check, this monthly cost represents a significant portion of their income. The SLMB program removes this burden by having Medicaid pay the premium directly to Medicare on behalf of the beneficiary.

Unlike other Medicaid programs that cover medical services like doctor visits or hospitalizations, the SLMB program covers only the Part B premium payment. It does not pay deductibles, copayments, or coinsurance amounts. Understanding this distinction is important because people often assume SLMB provides broader Medicaid coverage when it actually focuses on a single, specific expense.

Practical Takeaway: The SLMB program is specifically designed to help Medicare beneficiaries afford Part B premiums through Medicaid. The program has strict income and resource limits that vary by state, and the benefit covers only the monthly premium amount, not other out-of-pocket medical costs.

Income and Resource Limits for SLMB Coverage

Each state manages its own SLMB program within federal guidelines, which means income limits can differ significantly depending on where a person lives. The federal guideline suggests an income limit of 120% of the federal poverty level, but some states set their limits higher. For example, New York may have a different income threshold than Texas. These variations make it essential to check with your specific state's Medicaid office for accurate numbers.

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In 2024, the federal poverty level for a single person is $14,580 annually, making the typical SLMB income limit approximately $17,500. For a married couple, the poverty level is $19,060, with the SLMB limit around $22,872. However, these are federal guidelines—your state may use slightly different calculations. Income includes Social Security benefits, pensions, wages, rental income, and interest earnings. Some types of income may be excluded, such as certain types of home repair assistance or food stamps.

Resource limits refer to the total value of assets a person owns, excluding the home they live in and one vehicle. As of 2024, the typical resource limit is $8,820 for an individual and $13,230 for a couple. Resources include bank accounts, stocks, bonds, and other investments. The home and one car do not count toward this limit. Having resources above these limits may affect coverage, though some states have options for individuals slightly over the limit.

States calculate net monthly income by taking gross income and subtracting certain expenses. Some states allow deductions for medical expenses, insurance premiums, or work-related costs. The specific rules for what can be deducted vary significantly by state. This is why two people with identical incomes might have different coverage outcomes depending on where they live and what deductions their state allows.

Practical Takeaway: SLMB income and resource limits are set by individual states within federal guidelines. Most limits fall around 120% of the federal poverty level, but you should contact your state Medicaid office directly to learn the exact thresholds that apply in your location and how your specific income and resources will be counted.

How to Gather Information About SLMB in Your State

Finding information about the SLMB program in your state requires contacting the right government office. Each state has a Medicaid agency that manages programs like SLMB, though the agency may have a different name depending on the state. In some states, it's called the Department of Medical Assistance; in others, it's the Department of Human Services or Health and Human Services. The easiest way to find your state's Medicaid office is to visit Medicaid.gov, where you can search by state and find contact information.

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When you contact your state's Medicaid office, have some basic information ready. You will likely need your Social Security number, proof of citizenship or immigration status, and details about your income and resources. Many states now have online portals where you can view program information and documents, though these vary in user-friendliness. Some states offer phone support, while others require in-person visits to local offices. Rural areas may have limited office locations, so be prepared to travel or use mail-based processes.

Beyond your state Medicaid office, several national resources provide general information about SLMB. The Centers for Medicare & Medicaid Services (CMS) website includes fact sheets about the program. The Medicare.gov website offers plain-language explanations of how SLMB works and how it relates to other Medicare savings programs. The National Council on Aging also provides educational materials about SLMB and similar programs. These national resources give you background information, but your state Medicaid office provides the specific rules that apply where you live.

Many states allow people to request information about SLMB through multiple channels—phone calls, email, mail, or in-person visits. If English is not your primary language, federal law requires states to offer interpretation services at no cost to you. Likewise, if you have a disability that makes standard communication difficult, states must provide reasonable accommodations. Ask specifically about these services when you contact your state office.

Practical Takeaway: Start your research by finding your state's Medicaid office using Medicaid.gov, then contact them directly for information about SLMB income limits, the process for gathering documentation, and how the program works in your state. Use national resources like Medicare.gov and the National Council on Aging for general background information.

The SLMB Application Process and Required Documentation

The process for requesting SLMB coverage varies by state, but most states use a written form that asks for basic personal information, income details, and resource information. States typically provide these forms through their Medicaid office website, by mail, or at local Medicaid offices. Before starting any paperwork, gather documents that support the information you will provide. The state will likely request proof of income, identification, proof of citizenship, and documentation of your resources.

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For income documentation, Social Security statements or benefit verification letters serve as proof of monthly Social Security income. If you receive a pension, you will need recent pension statements. For employment income, recent pay stubs or a letter from your employer showing wages are typical requirements. If you have rental income or investment income, statements from banks or property management companies work as documentation. Some states accept bank statements showing regular deposits as income proof.

Resource documentation includes bank statements for all accounts, statements from investment accounts, and proof of property ownership. Most states ask for bank statements from the past one or two months showing account balances. If you own property other than your primary home, you may need to provide property tax documents or a letter from your county assessor showing the property value. Vehicle ownership typically requires the vehicle title and possibly a copy of your vehicle registration.

Citizenship and identity documentation usually means a birth certificate, passport, or naturalization papers. For identification, a driver's license or state ID card is typical. If you do not have these documents, the state can help you obtain them, though this may take time. Some states allow alternative documentation if original documents are unavailable. Once you gather documents, you can submit them to your state through mail, online portals, or in-person office visits, depending on what your state offers.

Practical Takeaway: Begin gathering documentation before contacting your state Medicaid office. You will likely need recent statements showing income and resources, proof of citizenship and identity, and proof of Medicare enrollment. Ask your state office which specific documents they require and how long they typically take to