Basic Considerations
To be eligible under this COA, an A/R must meet the following conditions:
The A/R is enrolled in Medicare Part A, Parts A and Part B, or Part B only.
The A/R meets all basic eligibility criteria. Because SLMB recipients receive Medicare, they are exempt from the citizenship verification requirement. Citizenship was verified by SSA prior to awarding Medicare. The Declaration of Citizenship form is still required. Third Party assignment, Length of Stay (LOS) and Level of Care (LOC) are not requirements under this COA.
The A/R has countable resources of less than or equal to the current QMB/SLMB/QI-1 resource limit.
The A/R has countable net income of less than the SLMB income limit but greater than the QMB income limit.
SLMB pays only the monthly premium for Part B Medicare for the SLMB eligible individual.
Retroactive coverage (three months prior) is allowed under this COA. SLMB eligibility cannot pre-date January 1993.
The SLMB income limit is based on the federal Poverty level (FPL). The FPL/SLMB income limit is subject to change between February and April of each year. Therefore, the annual January RSDI COLAs are disregarded in determining SLMB eligibility until the effective month of the new SLMB income limit.
In-kind support and maintenance (ISM) is NOT considered in determining SLMB eligibility.
THE STANDARD OF PROMPTNESS FOR PROCESSING A SLMB APPLICATION IS 10 WORKING DAYS FROM THE DATE OF RECEIPT OF THE APPLICATION.