California SLMB and QI Programs: Eligibility, Differences and Benefits

SLMB and QI: The Two Programs Above QMB

Most conversations about California's Medicare Savings Programs focus on QMB, the tier that covers everything. But SLMB and QI exist specifically for people whose income is too high for QMB but who still can't comfortably absorb the Part B premium.

Both programs do the same thing: California pays the $202.90 monthly Medicare Part B premium on your parent's behalf. That's $2,434.80 per year in assistance; for beneficiaries receiving Social Security, the net payment typically rises by that amount after withholding stops.

Neither covers deductibles, coinsurance, or Part A premiums. Those remain your parent's responsibility (or are handled by Medigap or Medicare Advantage if they have supplemental coverage). But both programs automatically trigger Extra Help with Part D prescription drug costs — no separate application needed.

The 2026 Income Thresholds

SLMB is the tier above QMB, and QI extends eligibility to a higher income limit:

After the $20 monthly unearned income disregard, the effective countable ceilings are $1,616 (SLMB single) and $1,816 (QI single). For couples: $2,184 (SLMB) and $2,455 (QI).

Both programs use the same $130,000 single / $195,000 couple asset limits as QMB, with the same exemptions for the family home, one vehicle, and burial resources.

Key Differences Between SLMB and QI

Retroactive coverage: SLMB can cover up to three calendar months before the month of application, provided your parent was eligible during those months. This means filing now could recover premiums already deducted from the last three Social Security checks. QI also allows up to three calendar months retroactive coverage under the same conditions.

Funding: SLMB is an open-ended Medicaid entitlement — California can't run out of money for it. QI runs on a capped annual federal grant, distributed first-come, first-served. In practice, California has managed QI allocations to avoid waitlists, but the structural difference means QI eligibility isn't guaranteed the way SLMB is.

Medi-Cal compatibility: QI is strictly mutually exclusive with full-scope Medi-Cal. If your parent qualifies for full-scope Medi-Cal, they can't receive QI benefits. SLMB can coexist with other Medi-Cal categories.

Who Falls Into These Programs

Here's a common scenario: a parent receives $1,500 per month from Social Security. That's above the QMB gross limit of $1,330 — so no QMB. But it's well below the SLMB limit of $1,596. After the $20 disregard, countable income is $1,480.

That parent qualifies for SLMB. California picks up the $202.90 Part B premium, effectively increasing their disposable income by that amount every month. They also get automatic Extra Help, which cuts prescription drug copays dramatically.

Another scenario: a parent with a small pension plus Social Security totaling $1,790 gross per month. That's over the SLMB limit of $1,596 but under the QI limit of $1,796. After the $20 disregard, countable income is $1,770 — QI eligible.

How to Apply

The application process is identical to QMB — apply through BenefitsCal, your county welfare office, or by submitting Form MC 14A. The county evaluates your parent for the highest tier they qualify for, so you don't need to specify SLMB or QI on the application.

Once approved, it takes 60 to 90 days for the inter-agency data exchange between the county, DHCS, CMS, and SSA to update the premium record. If your parent receives Social Security, SSA stops the premium deduction after that update and refunds deductions for months after the effective coverage date.

For the full application walkthrough — including what documents your county will need and how to track the premium refund timeline — see our California Medicare Savings Programs & Extra Help Guide.

See more California guides →