On April 1, 2016, most Iowa Medicaid programs were joined together into one managed care program called IA Health Link. Most existing Medicaid members were enrolled in IA Health Link on April 1, 2016, and most new members who become eligible after April 1, 2016, will also be enrolled in IA Health Link. SLMB members are excluded from the IA Health Link program.
What are the eligibility requirements for SLMB?
Limited Medicaid benefits are available to a person who meets all of these conditions:
- Is entitled to Medicare Part A, which provides benefits for hospital care.
- Has net countable monthly income that exceeds 100% of the federal poverty level for the family size but is less than 120% of this level.
- Member does not qualify for any other kind of Medicaid.
| FOR FAMILY SIZE: | INCOME IS OVER: | BUT IS LESS THAN: |
|---|---|---|
| Individual | $990 | $1,188 |
| Couple | $1,335 | $1,602 |
What services are covered by SLMB?
- Medicaid will pay the cost of the Medicare Part B premiums for Specified Low-Income Medicare Beneficiaries (SLMBs). Part B premiums are the only service Medicaid offers for this group. Medicare copayments, deductibles, and Part A premiums are not covered.
- SLMB status will also automatically qualify a member for the Medicare Part D financial Extra Help program. The Medicare Part D Extra Help program will help you pay your Medicare Part D prescription drug plan premiums, provide lower co-payments on your medications, and remove the Donut Hold or Coverage Gap from your prescription drug coverage.
SLMB Income and Resource Limits in 2016:
| FOR FAMILY SIZE: | MONTHLY INCOME LIMIT IS: | RESOURCE LIMIT IS: |
|---|---|---|
| Individual | $1,359 | $8,400 |
| Couple | $1,831 | $12,600 |