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Title 8: Medicaid Page 104 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Non-MAGI-Related Coverage Groups Revised October 10, 2025 People in Medicare Savings Programs NOTE: People applying for SLMB may refer to the coverage group as the “Medicare savings program,” since Medicare uses this term to identify the SLMB group. A person who wants this coverage must enroll in Medicare Parts A and B. A person who chooses not to enroll for Medicare Part A benefits cannot be eligible under SLMB. The state will not enroll people for Medicare Part A under SLMB. If the person does not enroll for Part A, it does not affect the person’s eligibility for other Medicaid coverage groups.

Mr. S, aged 70, is receiving social security benefits and is currently receiving Medicare Part A and Part B benefits. His income and resources are within limits for the SLMB coverage group. All other general Medicaid eligibility requirements are met. Mr. S’s application may be processed for the SLMB coverage group. When Medicaid eligibility ends, the client is responsible for paying the Medicare Part B premiums. Federal financial participation for Medicare Part B is available for all people who meet SLMB requirements. Therefore, it is necessary to identify these people on the system. Enter the poverty level on the system for each person on the case. Enter the poverty level on the ABC system for each person on the Medically Needy case. Also, enter an “L” in the QMB indicator for each person on Medically Needy with a zero spenddown who is eligible for SLMB. All clients who meet SLMB requirements are sent on the Medicare buy-in tape as SLMB-eligible, including those who have full Medicaid benefits, unless the client refuses SLMB coverage. When the buy-in tape is sent, the third-party system checks clients coded eligible for SLMB to see if the client has Part A entitlement. If the client does not have Part A entitlement, the third-party system rejects the record and the state is not billed for the client’s Medicare Part B premium. Calculate net countable monthly income using SSI policies. Allow the earned and unearned income exclusions. Consider the income prospectively.