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Aged, Blind, Disabled Section: Medicare Savings Program Policy Manual: 120.015 Chapter: Specified Low Income Medicare Beneficiary

Legal Authority: Social Security Act § 1902(a)(10)(E), § 1905(p)(2)(D); 42 CFR 435.406; Tenn. Comp. R. & Regs. 1200-13-20-.08(7)(b)

1. Overview Effective January 1, 1993, Section 4501(b) of the Omnibus Budget Reconciliation Act (OBRA) of 1990 required states to pay Medicare Part B premiums for individuals whose income exceeds QMB standards but is less than a specified higher percentage of the Federal Poverty Level (FPL). The coverage is called Specified Low-Income Medicare Beneficiaries (SLMB). 2. Policy Statement To be eligible in the SLMB category an individual must be entitled to Medicare Part A, have income that is at least 100% FPL but less than 120% of the FPL, and not have resources over $9,950 for an individual or $14,910 for a couple.

3. SLMB Benefits Medicaid benefits available to SLMB enrollees only include payment of Medicare Part B premiums. If an applicant is approved for SLMB and previously refused Part B coverage, the SLMB approval will automatically establish Part B coverage.

4. SLMB Effective Date Eligibility begins the date a TennCare application or Low-Income Subsidy (LIS) application is filed or the date all eligibility requirements are met, whichever is later. 5. Non-Financial Eligibility Requirement a. Medicare Part A (Hospital Insurance) Individuals must be entitled to Medicare Part A benefits. Individuals may be either entitled to receive premium-free Medicare Part A, or eligible to purchase Medicare Part A. See the Medicare Savings Program Overview policy.

TennCare will use an individual’s Social Security Number (SSN) to verify his entitlement to Medicare Part A benefits with the SSA.