SLMB Program: What It Pays For and Who Qualifies in 2026

Updated August 2026

Medicare's Part B premium jumped to $202.90 a month in 2026 — nearly $10 more each month than many people expected. For retirees living mostly on Social Security, that deduction is often their single largest health expense. The Specified Low-Income Medicare Beneficiary benefit, better known as SLMB, exists for exactly this situation: your state pays that premium for you, adding roughly $2,435 a year back to your Social Security check.

SLMB sits in the middle tier of the Medicare Savings Programs. It asks a little more income flexibility than QMB but far less than most people assume — and in 2026, new federal rules made applying easier than ever.

What Is SLMB?

SLMB is a state-run benefit, funded jointly with the federal government, that pays the Medicare Part B premium for people with limited income. It is one of four Medicare Savings Programs, alongside QMB, QI, and QDWI. Each targets a different income band; SLMB covers Medicare beneficiaries earning between roughly 100% and 120% of the federal poverty level.

If you're approved, your state pays the $202.90 monthly premium directly, and Social Security stops deducting it from your check. You'll see the difference in your deposit — usually within a month or two of approval, and states can refund premiums retroactively for up to three months before your application date.

Enrollment comes with a second, less obvious benefit: it automatically qualifies you for Extra Help, the federal subsidy that slashes Medicare Part D prescription costs. In 2026, Extra Help caps copays at $5.10 for generics and $12.65 for brand-name drugs, and can eliminate your drug plan premium and deductible entirely. For many enrollees, that's worth more than the premium coverage itself.

SLMB Income Limits for 2026

Eligibility limits are set each year using the federal poverty level. For 2026, the monthly income limits in most states are:

  • Individual: $1,616 per month
  • Married couple: $2,184 per month

Two things make these numbers more forgiving than they look. First, they already include the standard $20 general income disregard — the first $20 of most monthly income simply isn't counted. Second, if you still work, the first $65 of earnings plus half of everything above that is excluded too. Your gross income can be meaningfully higher than the published limit and you may still qualify.

Alaska and Hawaii use higher limits because their poverty guidelines are higher, and a number of states have expanded their thresholds beyond the federal minimums. If your monthly income is within a couple hundred dollars of the cutoff, apply anyway — the math your state runs is friendlier than the headline figure.

Asset Limits and the States That Skip Them

Most states also apply a resource test. The 2026 asset limits for SLMB are $9,660 for an individual and $14,470 for a married couple. Before you count yourself out, know what's excluded: your home, one vehicle, household goods, burial funds up to a set amount, and the cash value of certain life insurance policies don't count. For most applicants, the asset limit only looks at bank accounts, investments, and similar liquid savings.

Twelve jurisdictions have eliminated the resource test entirely as of 2026: Alabama, Arizona, Connecticut, Delaware, Louisiana, Massachusetts, Mississippi, New Mexico, New York, Oregon, Vermont, and the District of Columbia. Live in one of these and your savings don't matter at all.

Federal rules effective by April 2026 also require states to accept self-attestation of resources — you state your asset amounts, and in most cases you no longer have to gather bank statements to prove them.

What SLMB Pays For — and What It Doesn't

SLMB covers exactly one thing, but it's a big one:

  • Medicare Part B premium: $202.90/month in 2026, about $2,435 per year
  • Automatic Extra Help for prescriptions: worth $2,000–$5,000 a year for many enrollees

It does not pay the Part A premium, the Part B deductible ($283 in 2026), or your 20% coinsurance. Those richer benefits belong to QMB, the lower-income tier. SLMB enrollees who want help with remaining out-of-pocket costs often pair the benefit with a Medicare Advantage plan — many plans in the same low-income bracket offer $0 premiums, dental and vision coverage, or a flex card for groceries and household items.

SLMB vs. QMB vs. QI

The three main tiers of this Medicare program family differ only by income band and depth of coverage:

  • QMB (up to 100% FPL — $1,350 single / $1,824 couple in 2026): pays Part A and B premiums, both deductibles, and all coinsurance. See our QMB guide.
  • SLMB (100–120% FPL — $1,616 / $2,184): pays the Part B premium only.
  • QI (120–135% FPL — $1,816 / $2,455): pays the Part B premium only, but funding is capped by Congress and granted first-come, first-served — apply early in the year.

You can only be enrolled in one tier, and your state assigns you to the one your income fits. All three trigger automatic Extra Help.

How to Apply for SLMB

Applications go through your state Medicaid agency — not Social Security, and not Medicare.

  1. Confirm you have both Medicare Part A and Part B.
  2. Gather your Medicare card, Social Security award letter or other proof of monthly income, and — in states that still check resources — recent bank statements.
  3. Contact your state Medicaid office. Call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov/contacts to find it. Most states accept applications online, by mail, by phone, or in person.
  4. Wait for a decision — states must process applications within 45 days.
  5. Reapply or renew annually; most states send a renewal notice.

If you're denied for being slightly over the eligibility limits, ask about QI, and check Extra Help separately through Social Security — its cutoff is higher, around 150% of the poverty level.

Frequently Asked Questions

What does SLMB coverage mean?

SLMB coverage means your state Medicaid program pays your monthly Medicare Part B premium — $202.90 in 2026 — so it's no longer deducted from your Social Security check. It doesn't change your Medicare coverage itself; you keep the same doctors and benefits, and you also get automatic Extra Help with prescription costs.

Is SLMB better than QMB?

QMB provides more: it pays premiums, deductibles, and coinsurance, while SLMB pays the Part B premium only. But QMB's income cutoff is lower ($1,350/month for an individual in 2026 versus $1,616 for SLMB). You don't choose between them — your state enrolls you in the tier that matches your income, and SLMB is the best available option if you earn between 100% and 120% of the poverty level.

What are the SLMB income limits in Texas for 2026?

Texas uses the federal standard: $1,616 per month for an individual and $2,184 for a married couple, including the $20 disregard. Texas still applies the resource test — $9,660 single / $14,470 married — and takes applications through Your Texas Benefits.

What are the income limits for Part D Extra Help in 2026?

Extra Help reaches higher than any Medicare Savings Program tier — about 150% of the federal poverty level, roughly $1,995 a month for a single person in 2026. SLMB, QMB, and QI enrollees get it automatically; everyone else can apply directly through Social Security. See our Medicare Extra Help guide for the full rules.

Getting the premium paid is step one; low-income Medicare beneficiaries often qualify for more than one benefit at once — a Part B giveback, a grocery allowance, or dental coverage through the right plan. Our free eligibility check takes about two minutes and shows what's available in your ZIP code, with no obligation. See what you may qualify for today.