Specified Low-Income Medicare Beneficiary (SLMB)
- Program to pay Medicare Part B premiums for those whose income is above the QMBP standard.
- Person must be enrolled in Part A Medicare and paying any associated fees if they have them
- Persons on one of the LTC medical programs (ADvantage, Nursing Home, DDS) can also be eligible for SLMB,
- Eligibility for LTC and SLMB are determined separately and by their respective policies
- SLMB benefit can start up to three months prior to date of application if all factors of eligibility are met
- For a couple who are both eligible for Medicare, total countable income must be equal to or less than the SLMB standards for a couple.
For any individual that is determined eligible for long-term care, refer to policy 317:35-15-1.
Note: If a nursing home client’s income falls close to the SLMB guidelines (within the $20 general income exclusion), and an edit is created; do not add the individual to SLMB. Allow the medical expense instead in the vendor payment calculation.
Cases that were previously or are currently used for active TANF benefits should not be used for ABD and buy-in benefit cases.
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