Specified Low Income Medicare Beneficiaries (SLMB) and Qualifying Individuals (QI)

These programs may help pay your Medicare Part "B" Premiums.

  • Is entitled to Medicare Part A hospital insurance
  • Has countable income between 120% and 135% of the Federal Poverty Level
  • Has countable resources below the limit ($7,730 for an individual and $11,600 for a couple)
  • Is not otherwise eligible for full Medicaid benefits
Income Limit: 

Family Size






(Eff. 03/01/2019) 

1 (Individual)



2 (Couple)




For a SLMB or a QI, Healthy Connections is required to pay the Medicare Part B premium only. These individuals are not entitled to any other Medicaid benefits; therefore, they do not receive a Medicaid card.

To Apply: 

Apply online or complete the following form and submit it to your local county officeAdditional Information for Select Medicaid ProgramsIf you elect to file a hardcopy application, you may complete the following forms and submit them to your county office 

Report Fraud