Medicaid: Specified Low Income Medicare Beneficiary Program

Who is eligible?

You may be eligible for the SLMB Program if you:

• Are entitled to Medicare Part A or Part B-ID benefits.
• Have countable assets at or below the program limit.
  • If it’s just you, you cannot have more than $9,430 in assets
  • You and your spouse cannot have more than $14,130 in assets.
• Have countable monthly income between 100% and 120% of the federal poverty level after certain credits are applied.
  • If it’s just you, you must make between $1,255 and $1,506 each month.
  • You and your spouse must make between $1,703.33 and $2,044 each month.

Asset and income limits are based on federal guidelines, which may change each year.

How do I apply?

You can apply:

• Online.
• By phone.
• In person.
• By mail.

Learn how to apply.

How do payments work?

If you are eligible for the SLMB Program, Medicaid will start paying your Medicare Part B or Part B-ID premiums up to three months before the date of your application.

When that happens, your Social Security payment will go up because the premiums for Medicare Part B or Part B-ID will no longer be deducted. You’ll get a notice from the Social Security Administration. They’ll give you a refund for any payments you made after the date you were enrolled in the SLMB Program.

Your Social Security payment may not change for one to three months, though. That’s because it takes time for Medicaid, Medicare, and the Social Security Administration to adjust payments. This means your payments may be higher than usual for a short time.

Example: If your application was approved in April for the months of April, March, and February, you’re enrolled in the SLMB Program in May. Your Social Security payment may not change until July. You’ll get a refund for premiums you paid for February, March, April, May, and June.

Who do I contact for help?

You can call the Wisconsin Medigap Helpline at 800-242-1060. You can also contact your local benefit specialist.