SLMB Explained: How the Specified Low-Income Medicare Beneficiary Program Works in 2026

The Specified Low-Income Medicare Beneficiary (SLMB) program pays your entire Medicare Part B premium — $202.90 a month in 2026, or $2,434.80 over the year (CMS, 2026 Medicare Parts A & B Premiums and Deductibles). To qualify in most states, your countable monthly income generally falls between $1,350 and $1,616 if you are single, or between $1,824 and $2,184 if you are married. That one benefit puts about $2,435 back in your budget every year without changing anything about how your Medicare works.

What Is SLMB?

SLMB is one of the four Medicare Savings Programs run jointly by Medicare and your state Medicaid agency. It is designed for people whose income is a little too high for the more generous QMB program but still below 120% of the federal poverty level. If you qualify, your state pays the monthly Part B premium on your behalf, and that premium is no longer deducted from your Social Security check — so the savings often show up as a higher monthly deposit.

SLMB does one thing, and it does it completely: it covers the Part B premium. It does not touch your deductibles, coinsurance, or copayments. If you need help with those out-of-pocket costs too, the program you want is QMB, which sits one income tier below SLMB.

2026 SLMB Income Limits

For 2026, the federal baseline SLMB income limits that most states use are $1,616 a month for an individual and $2,184 a month for a married couple. There is also a lower threshold: if your income is at or below the QMB limit of $1,350 (single) or $1,824 (couple), you qualify for QMB instead, which is a better deal. In other words, SLMB targets the income band just above QMB.

Two important caveats apply. Alaska and Hawaii use higher limits because their federal poverty guidelines are higher — Alaska multiplies the figures by roughly 1.25 and Hawaii by about 1.15. And the number that matters is your countable income, not your gross income.

Before your income is compared to the limit, federal rules subtract a $20 general disregard, plus more if you have earned wages. Many people who look ineligible on paper actually qualify once those disregards are applied. We walk through the math in how the $20 income disregard works.

The fastest way to know which tier you land in is to run your real numbers. Check your MSP eligibility in about two minutes — it applies the disregards and your state's limits automatically.

What SLMB Pays For — and What It Doesn't

SLMB covers exactly one cost: your Medicare Part B premium. Here is what that means in practice for 2026.

• Part B premium — fully paid. That is $202.90 a month, or $2,434.80 a year, that you no longer pay.
• Part B deductible ($283 in 2026) — not covered. You still pay it.
• Part A and Part B coinsurance — not covered. You remain responsible for the usual 20% Part B coinsurance and any hospital costs.
• Part D prescription Extra Help — included automatically (more on this below).

That last point is easy to overlook and genuinely valuable. Everyone enrolled in any Medicare Savings Program — including SLMB — is automatically deemed eligible for the Part D Low-Income Subsidy, also called Extra Help, which the Social Security Administration estimates is worth about $5,700 a year (SSA, Extra Help with Medicare prescription drug costs). You do not have to file a separate application for it.

SLMB vs. QMB vs. QI

The three Medicare Savings Programs form an income ladder. QMB is the lowest income tier and covers the most; QI is the highest tier and, like SLMB, covers only the Part B premium. SLMB sits in the middle. The full side-by-side comparison lives in our guide to which MSP tier you qualify for, but here is the short version.

• QMB (up to $1,350 single / $1,824 couple): pays the Part B premium plus Part A and B deductibles, coinsurance, and copays.
• SLMB (up to $1,616 single / $2,184 couple): pays the Part B premium only.
• QI (up to $1,816 single / $2,455 couple): pays the Part B premium only, but is first-come, first-served and funded by a limited federal block grant.

One practical advantage of SLMB over QI: SLMB is an entitlement, so as long as you meet the limits you cannot be turned away for lack of funding. You can read more on our SLMB program overview.

Is There an Asset Test for SLMB?

In most states, yes. The 2026 federal asset limits are $9,950 for an individual and $14,910 for a couple, and they exclude your home, one car, and personal belongings. About ten states have dropped the asset test entirely, so only income matters there. See what counts toward MSP asset limits and the states with no asset test for the details.

A Real Example

Consider Maria, a 71-year-old widow in Ohio whose only income is a $1,580 monthly Social Security benefit. After the $20 general disregard, her countable income is $1,560. That is above the 2026 QMB limit of $1,350 but below the SLMB limit of $1,616, so she qualifies for SLMB. Her state begins paying her $202.90 Part B premium, her Social Security deposit rises by that amount, and she is automatically enrolled in Extra Help for her prescriptions. Her gross annual gain: roughly $2,435 in premium relief plus substantial drug savings.

How to Apply for SLMB

You apply through your state Medicaid office, not Social Security, because SLMB is administered at the state level. Before you apply, it helps to know which tier you are likely to land in so you can confirm the office processed your application correctly. Start by checking your eligibility with our free tool, then contact your state Medicaid agency to file. Many states also let SLMB approvals reimburse Part B premiums you paid for up to three months before your application date.

This article is for general educational purposes and is not legal, tax, or financial advice. Income limits, asset rules, and premiums change annually and vary by state. Confirm your eligibility with your state Medicaid agency or a licensed Medicare counselor before making decisions.