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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued Feburary 06, 2023 Page 1 of H-1300 Replacing March 13, 2020 Revised/added text indicated by underscore Deleted text indicated by “**” H-1300 SPECIFIED LOW-INCOME MEDICARE BENEFICIARY (SLMB) H-1310 GENERAL INFORMATION

Effective January 1, 1993, the Omnibus Reconciliation Act (OBRA) of 1990 required payment of Medicare Part B premiums for a mandatory eligibility group of low income Medicare beneficiaries called Specified Low Income Medicare Beneficiaries (SLMB).

The applicant/beneficiary must meet all of the following SLMB requirements.

A SLMB must:

• Be enrolled in hospital insurance benefits under Medicare Part A, but does not have to be currently enrolled in Medicare Part B;

• Have income that is greater than 100 percent but less than 120 percent of the Federal Poverty Income Guidelines (FPIG). Refer to Z-200 Federal Poverty Income Guidelines; and

NOTE: In January of each year, disregard the Social Security Administration (SSA) cost of living adjustment (COLA) through the month following the release of the annual FPIG update. Thereafter, determine eligibility using all income including the COLA for the current year.

• Meet all non-financial eligibility requirements for Medicaid.

H-1310.1 COVERAGE

SLMB Only

• Eligible for Medicaid payment for the Medicare Part B premium only.

SLMB Plus

• Eligible for Medicaid payment for the Medicare Part B premium; and