Help Paying Medicare Part B Premium in Pennsylvania
Two Pennsylvania Programs That Pay Your Part B Premium
If the $202.90 monthly Part B premium deduction is shrinking your Social Security check, Pennsylvania has two Healthy Horizons tiers designed specifically for this:
SLMB (Specified Low-Income Medicare Beneficiary) — for individuals with countable monthly income between $1,351 and $1,616 (couples: $1,825–$2,184). Resource limit: $9,950 single, $14,910 couple.
QI (Qualifying Individual) — for individuals with countable monthly income between $1,617 and $1,816 (couples: $2,185–$2,455). Same resource limits.
Both programs pay your full Part B premium. The difference is funding: SLMB is an entitlement, while QI runs on a capped federal grant with first-come, first-served enrollment after prior-year recipients are re-enrolled.
If your income falls below $1,350 (single), you qualify for QMB instead, which covers premiums plus deductibles and copays.
The $20 Disregard That Might Qualify You
Pennsylvania subtracts $20 from your gross unearned income before comparing it to the limits. If your Social Security check is $1,636 per month, your countable income is $1,616 — right at the SLMB ceiling.
Many people look at the published limits, compare them to their gross check, and assume they're over. But the $20 disregard means the real cutoff is $20 higher than it appears.
What Happens to Your Social Security Check After Approval
Once the County Assistance Office approves your SLMB or QI application, Pennsylvania transmits an electronic record to CMS, which notifies Social Security to stop deducting the Part B premium from your check.
This process takes 60 to 90 days. During that window, Social Security keeps deducting $202.90 each month. Your check stays small for two or three months after approval — this is normal, not a sign that something went wrong.
When the systems sync, SSA stops future deductions and deposits a lump-sum reimbursement covering every month of back-deductions from your effective coverage date forward. For SLMB and QI, coverage can be retroactive up to three months before your application, so the refund check can be substantial.
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How to Apply
File Form PA 600 M at your County Assistance Office, through the COMPASS portal at compass.dhs.pa.gov, or by phone at 1-866-550-4355. You can also trigger a Pennsylvania MSP application by filing the federal Extra Help application (Form SSA-1020) with Social Security — the data transfers automatically under MIPPA.
You'll need recent bank statements, pension pay stubs (if any), and proof of Pennsylvania residence. The CAO must process your application within 45 calendar days.
The Extra Help Bonus
Any SLMB or QI approval automatically qualifies you for federal Part D Extra Help (Low-Income Subsidy), which reduces your prescription drug copays and may eliminate your Part D plan premium and deductible. You don't need to apply separately — the MSP enrollment triggers it.
For the complete application walkthrough, premium refund timeline tracker, and net income worksheet, see the Pennsylvania Medicare Savings Programs, Extra Help & PACE/PACENET Guide.
Get Your Free Pennsylvania — Medicare Savings Program Eligibility Checklist
Download the Pennsylvania — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.