Last page edit 10/20/08

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Specified Low Income Medicare Beneficiary (SLMB)

and

Qualified Individual (QI)

Name   Specified Low Income Medicare Beneficiary (SLMB) - pronounced "slimby", and

"Qualified Individual " (QI) - limited expansion of SLMB.
Non-Financial Eligibility Conditions   These are state programs, similar to medical assistance, for people who need help paying for Medicare services.
  • You must be eligible for Medicare Part A (even if not currently enrolled)
  • But NOT financially eligible for medical assistance
  • And have limited income and assets (see below)
Income Eligibility Conditions   (Apply $20 income disregard - see note below)
There are two levels of monthly income:
SLMB

(100-120%- annual federal poverty guidelines)

 QI

(120-135% of annual federal poverty guidelines)
 Individual: $1,060 $1,190
 Couple: $1,420 $1,595

Effective April 2008

  • Income limits for eligibility in Medicare Buy-in programs may be higher in some states.

Note: $20 may be subtracted from the individual's or couple's gross income; if the $20 subtraction reduces the income to the number listed above, then the individual or couple probably qualifies for the benefit.

Do these numbers change?
Asset Eligibility Conditions   Assets not over:
Individual: $4,000
Couple:    $6,000
  • These limits apply to personal assets including cash, bank accounts, stocks and bonds.
  • These limits do not include home, car or $1,500 in burial fund.
  • Some states have no assets limits.
Benefit  
  • SLMB & QI pay your Medicare Part B premiums only.
  • To receive prescription drug benefits beginning in 2008, you must enroll in a Medicare prescription drug plan by 2007
Apply At  
  • Department of Social Services.  Find your local DSS Office
  • You must apply every year for these benefits.
  • If you meet the eligibility requirements, your application will be granted on a first come first serve basis, with priority given to those who received benefits the previous year.
Appeals

  

  • You can appeal any denial, termination, or reduction of benefits

  • Appeals must be filed in writing at the DSS office.  It is best to file it in person and to get a receipt showing that you filed the appeal.

  • Appeals must be filed within 90 days of the action, or you cannot appeal.

  • If you file within 10 days of notice that benefits are being terminated or reduced, they will continue until the decision.  If you do not appeal within 10 days, the termination or reduction will happen.
Source of the Funds    
You Also Would Be Eligible For    
Sources of Law

   Federal Law: 42 U.S.C. §§ 1396a(a)(10)(E), 1396(p)

Federal Regulations: 5 CFR Pt. 900, Subpt. F, App. A (Medicaid must be enacted) 42 C.F.R. 417

Federal Policy Materials:  The Federal Medicare Web Page, has questions and answers, help and general information.

State Law: Md. Ann Code  Health-General Art § 2-104(b), 15-103, and 15-105

State Regulations: COMAR 10.09.24 et seq.

State Policy Materials: 

Other   In each county and in Baltimore City, the Senior Information and Assistance offices help the elderly with information about community services, health care, housing, income and financial aid, as well as transportation; employment and training, and legal services. The offices also refer senior citizens to these services. You can find the phone number for your local Senior Information and Assistance office on the Department of Aging's web site, or you can call the Maryland Department of Aging at 1-800-AGE-DIAL, weekdays between 8:00 a.m. and 5:00 p.m.

Further information.
Source: Maryland Legal Assistance Network (MLAN), updated by the Maryland State Law Library (MSLL).

 Last review 10/20/08 (PLL/M.A.J.)
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