Medicare coverage, eligibility criteria, and associated prices for SLMB (Specified Low-Income Medicare Beneficiary) program
In 2025, the income and resource limits for Medicare Savings Programs (MSPs) vary by program and can differ somewhat by state. Here's a breakdown of the federal baseline limits and state variations for each program:
| Program | Income Limits (Monthly) 2025 (Individual/ Couple) | Resource Limits (Individual / Couple) | Notes | |--------------------------------|---------------------------------------------------|----------------------------------------------------|---------------------------------------------------------------------------------------| | **Qualified Medicare Beneficiary (QMB)** | $1,275 / $1,724 | $9,940 / $15,600 | Helps pay Medicare Part A & B premiums, deductibles, co-insurance. States may allow higher limits or disregard income/resources. | | **Specified Low-Income Medicare Beneficiary (SLMB)** | About $1,526 to $1,585 / $2,074 to $2,135 | $9,660 / $14,470 (varies by source) | Pays Medicare Part B premiums only. Some states have no asset/resource limit or override federal limits. | | **Qualifying Individual (QI)** | Around $1,695 / $2,313 | Same as SLMB, approximate | Covers Part B premiums for those not otherwise Medicaid-eligible; limited by annual federal funding. States can disregard income/resources. | | **Qualified Disabled and Working Individuals (QDWI)**| Higher income limits; must not be Medicaid eligible | Varies | Pays Part A premiums for certain disabled and working individuals. Income/resource limits are higher and vary more by state. |
It's important to note that federal limits are set annually and rounded up to the nearest dollar by CMS. States have significant flexibility to disregard income or assets, effectively raising eligibility limits or eliminating asset tests for these MSPs. Many states do not enforce a resource limit for MSPs even if the federal rule provides one.
Income figures often include a $20 or $30 disregard added to the Federal Poverty Level calculations. Asset/resource limits generally include countable assets per Medicaid rules but exclude primary residence and some other exempt assets.
For precise limits in any particular state, applicants should consult their state Medicaid agency as these limits can vary widely. Many states adopt higher income thresholds or do not apply asset limits, especially for SLMB and QI programs.
If you're interested in the detailed income/resource limits per state for all four MSPs, feel free to ask, and I can help locate or summarise those specifically upon request.
To apply for any Medicare Savings programs, a person can visit a specific website and click on their state. Keep in mind that even if your income seems higher than the limits, it's still advisable to apply because not all states consider certain items in their calculations.
Lastly, it's worth mentioning that there is a program called SLMP that helps people with low incomes pay Medicare Part B monthly premiums. This information was not mentioned in the provided text.
This flexibility allows states to tailor MSP eligibility to local needs.
- In addition to Medicare savings programs, there's also a program called SLMP that assists individuals with low incomes in paying their Medicare Part B monthly premiums.
- The federal rules for Medicare Savings Programs (MSPs) include asset limits, but many states do not enforce these limits, instead choosing to disregard income or assets, effectively raising eligibility limits or eliminating asset tests.
- If you're concerned about your eligibility for health insurance related to accident and falls under Medicare, it's crucial to consult your state Medicaid agency for the most accurate and up-to-date information on income and resource limits, as these can vary significantly from state to state.
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