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State of California Health and Human Services Agency ... You may apply for QMB, SLMB, or QI-1 by completing and mailing this form to ... MC 14 A (09/11).

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Home | Quality Means Business (QMB)

Monthly income levels that are at or below the following amounts may qualify for an MSP ProgramStatusIncome Limit*QMBSingle$2,564.00 /monthSLMBSingle$2,807.00 /monthALMBSingle$2,989.00 /month

To qualify for QMB, your monthly income cannot exceed $1,215 if you are single ($14,580/year) or $1,643 ($19,720/year) if you are part of a couple. Note: A $20 “disregard” is subtracted from your monthly income (earned or unearned).

If your income is slightly too high for you to qualify for QMB benefits, you may still be eligible for another state medical assistance program: Specified Low-Income Medicare Beneficiary (SLMB). The resource limits for SLMB eligibility are the same as for a QMB, but the income limits are 20% higher.

The first three programs (QMB, SLMB, QI) require that you have limited financial resources to qualify. In 2022, this would be no more than $8,400 for an individual and $12,600 for a married couple.

Under SLMB, Medicaid pays your Medicare Part B premium to Medicare for you. If you qualify for SLMB, you will not receive a monthly health card. You must pay your Medicare deductible and coinsurance. . Who is eligible to be a Qualified Individual-1 (QI-1)?

2023 Income and Resource Reference Chart IncomeLimitsIncome QMB Individual Income LimitLimits $1,133Income QMB Couple Income LimitLimits $1,526Income SLMB Individual Income LimitLimits $1,133 to < $1,359Income SLMB Couple Income LimitLimits $1,526 to < $1,83111 more rows • 1 Mar 2023

The Specified Low-Income Medicare Beneficiary (SLMB) program is one of four Medicaid-administered Medicare Savings Programs (MSPs).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232