Many Medicare beneficiaries struggle with the monthly cost of Medicare Part B premiums. For individuals with limited or moderate income, the SLMB (Specified Low-Income Medicare Beneficiary) and QI (Qualifying Individual) programs offer financial assistance to cover the full cost of the Part B premium. These programs are part of the federal Medicare Savings Program system and help millions of Americans reduce their out-of-pocket healthcare costs.
This guide explains how SLMB and QI work, who qualifies, what benefits they provide, how to apply, and how these programs differ from the more comprehensive QMB program.
What Are SLMB and QI Programs?
SLMB and QI are Medicare Savings Programs designed to assist Medicare beneficiaries who have limited income but do not qualify for the full coverage provided by QMB.
SLMB (Specified Low-Income Medicare Beneficiary)
Pays the Medicare Part B premium for individuals whose income is slightly above the QMB limit.
QI (Qualifying Individual Program)
Also pays the Medicare Part B premium, but has slightly higher income allowances than SLMB and must be renewed every year.
Both programs provide meaningful financial assistance to beneficiaries who need help with premium costs but do not require the more extensive cost-sharing coverage of QMB.
What SLMB Covers
SLMB provides assistance specifically for:
- Medicare Part B premium
- Automatic enrollment into Extra Help (LIS), which lowers prescription drug costs
SLMB does not cover:
- Deductibles
- Copayments
- Coinsurance
- Medicare Part A premiums
However, eliminating the Part B premium alone saves most individuals more than $2,000 per year.
What QI Covers
The QI program offers the same benefits as SLMB:
- Full payment of Medicare Part B premium
- Automatic enrollment into Extra Help
The significant differences include:
- QI is funded on a first-come, first-served basis
- Beneficiaries must reapply every year
- Individuals receiving Medicaid cannot qualify for QI
- Income limits are slightly higher, making QI available to individuals who earn too much for SLMB
Because QI funding is limited, early application is recommended each year.
How Much Can SLMB and QI Save You?
The standard Medicare Part B premium in 2025 is approximately $174.70 per month, totaling over $2,000 annually.
Both SLMB and QI will cover this amount entirely.
Additional savings may occur when Extra Help is automatically triggered:
- Lower prescription copays
- Reduced or eliminated Part D premiums
- No Part D late-enrollment penalty
- Reduced yearly drug spending
These combined savings can make a major difference for beneficiaries living on fixed incomes.
Who Qualifies for SLMB?
SLMB is designed for individuals who:
- Are enrolled in Medicare Part A
- Are enrolled in Medicare Part B
- Have income slightly higher than QMB limits
- Have limited financial resources
- Do not receive full Medicaid benefits
Income and resource limits vary by state but are typically set around 120% of the Federal Poverty Level.
SLMB is ideal for individuals who do not qualify for QMB but still need help covering their Part B premium.
Who Qualifies for QI?
QI is intended for individuals who:
- Are enrolled in Medicare Part A
- Are enrolled in Medicare Part B
- Have income above SLMB limits but below QI limits
- Have limited resources
- Are not enrolled in Medicaid
- Reapply annually before program funding runs out
Income limits typically fall around 135% of the Federal Poverty Level.
Because QI is funded on a yearly grant basis, states approve applications on a first-come, first-served system.
SLMB vs. QI: What’s the Difference?
Although both programs pay the Part B premium, key differences include:
| Feature | SLMB | QI |
|---|---|---|
| Part B Premium Covered | Yes | Yes |
| Automatic Extra Help | Yes | Yes |
| Covers Deductibles / Copays | No | No |
| Reapply Every Year | Not required | Required annually |
| Priority | Continuous | First-come, first-served |
| Medicaid Eligibility | Allowed | Not allowed |
| Income Limit | Lower | Higher |
Beneficiaries who exceed SLMB income limits often qualify for QI instead.
How to Apply for SLMB or QI
SLMB and QI applications are processed through the state Medicaid office in the state where you reside.
Step 1: Gather Documentation
Most states require:
- Medicare card
- Government-issued ID
- Proof of income
- Bank statements or resource information
- Proof of residency
- Social Security award letter
Step 2: Submit Your Application
You may apply:
- Online through the state Medicaid website
- By mail
- By phone (depending on state programs)
- In person at a Medicaid or social services office
Step 3: Wait for Determination
Processing typically takes 30–45 days.
If approved, benefits generally begin the first month after approval.
How SLMB and QI Work With Extra Help
Enrollment in either SLMB or QI triggers automatic qualification for Extra Help.
Extra Help lowers prescription drug costs by:
- Reducing or eliminating Part D premiums
- Lowering Part D deductibles
- Reducing medication copays
- Eliminating the Part D coverage gap for most medications
This combination of SLMB/QI plus Extra Help creates substantial savings on both medical and prescription costs.
Common Misconceptions About SLMB and QI
“I can’t get help because I already have a Medicare Advantage plan.”
False.
SLMB and QI work with Original Medicare or Medicare Advantage.
“I can’t qualify because I own a home or a car.”
False.
These assets are typically not counted.
“My income is too high.”
Many individuals mistakenly believe this.
Income rules are more flexible than most people realize.
“I’ll lose my doctor if I apply.”
Untrue.
SLMB and QI do not affect provider networks.
Who Benefits Most from SLMB and QI?
These programs are especially helpful for:
- Individuals living on Social Security alone
- Beneficiaries with moderate income that falls just above QMB eligibility
- People struggling to afford the Part B premium
- Retirees facing high prescription drug costs
- Individuals who do not qualify for full Medicaid
For these beneficiaries, SLMB or QI can dramatically reduce healthcare expenses.
Conclusion
The SLMB and QI Medicare Savings Programs offer valuable assistance to help eligible beneficiaries pay their Medicare Part B premiums. By eliminating this monthly expense and providing automatic enrollment into Extra Help, these programs significantly reduce both medical and prescription drug costs for millions of individuals.
If you are living on a fixed income or struggling with Medicare expenses, SLMB or QI may be the financial relief you need.
Need Help Applying for SLMB or QI?
Menke Insurance provides free assistance to help you determine eligibility, complete your application, and coordinate benefits with your Medicare plan.
Contact Menke Insurance today for free Medicare guidance and support.