Oklahoma SLMB and QI-1 Programs for Part B Premium
Three MSP Tiers — and Two of Them Only Cover the Premium
Oklahoma's Medicare Savings Programs have three tiers that most seniors encounter: QMB, SLMB, and QI-1. QMB is the most comprehensive — it pays premiums, deductibles, and all cost-sharing. But if your parent's income is above the QMB ceiling ($1,350/month individual in 2026), they may still qualify for SLMB or QI-1, which cover only the Medicare Part B premium.
That's still $202.90/month — $2,434.80/year — back in your parent's pocket.
SLMB: Income Between 100% and 120% FPG
SLMB (Specified Low-Income Medicare Beneficiary) covers the Part B premium for individuals with income between the QMB ceiling and 120% of the Federal Poverty Guidelines. In 2026, the SLMB income limits (including the $20 disregard) are:
- Individual: up to $1,616/month
- Couple: up to $2,184/month
- Asset limit: $9,950 individual, $14,910 couple
SLMB has an important advantage over QI-1: retroactive coverage. If your parent qualifies, SLMB can cover Part B premiums for up to three months before the application month. So if you apply in July, SLMB coverage can reach back to April, and SSA will refund the premiums deducted for those months.
SLMB enrollment also automatically triggers full Extra Help (Part D LIS), capping prescription costs at $5.10 generic and $12.65 brand-name.
QI-1: Income Between 120% and 135% FPG
QI-1 (Qualifying Individual) covers the same Part B premium as SLMB, with higher income limits:
- Individual: up to $1,816/month
- Couple: up to $2,455/month
- Asset limit: $9,950 individual, $14,910 couple
QI-1 also provides up to three months of retroactive coverage and triggers automatic Extra Help enrollment.
The key difference: QI-1 is funded by an annual federal block grant, so available funding is limited. Applying earlier in the calendar year can reduce the risk of funding being unavailable.
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How They Differ from QMB
| Feature | QMB | SLMB | QI-1 |
|---|---|---|---|
| Part B premium | Paid | Paid | Paid |
| Part A premium | Paid (if applicable) | Not covered | Not covered |
| Deductibles | Paid | Not covered | Not covered |
| Copays/coinsurance | Paid | Not covered | Not covered |
| Balance billing protection | Yes | No | No |
| Retroactive coverage | No (prospective only) | Up to 3 months | Up to 3 months |
| Income limit (individual) | $1,350 | $1,616 | $1,816 |
| Automatic Extra Help | Yes | Yes | Yes |
The most significant gap: SLMB and QI-1 enrollees are not protected from balance billing. If your parent needs surgery and the Part A hospital deductible is $1,736, they owe it themselves. QMB would cover it; SLMB and QI-1 do not.
Can You Have SLMB/QI-1 and a Medicare Supplement Plan?
Yes. Since SLMB and QI-1 only cover the premium, many families pair them with a Medigap plan (Medicare Supplement) to cover the cost-sharing gap. A Medigap Plan G, for example, covers the Part A hospital deductible and nearly all remaining cost-sharing.
The monthly Medigap premium is a separate cost, but for a senior with frequent medical needs, the combined savings of SLMB/QI-1 (eliminating the Part B premium) plus Medigap (eliminating cost-sharing) can provide comprehensive coverage at a net cost lower than paying everything out of pocket.
How to Apply
Both SLMB and QI-1 use the same application as QMB — Form 08MP003E through OKDHSLive (okdhslive.org) or any county OKDHS Human Services Center. OKDHS evaluates all MSP tiers from a single application, starting with QMB and working up. If your parent doesn't qualify for QMB, the caseworker should automatically check SLMB, then QI-1.
If the caseworker says "you don't qualify" without specifying which tier, ask explicitly: "Was my parent evaluated for SLMB and QI-1, not just QMB?" This is where caseworker errors are most common — stopping at the QMB denial without checking the higher-income tiers.
The Oklahoma Medicare Savings Programs & Extra Help Guide details how each MSP tier works in Oklahoma, the exact income calculations OKDHS uses, and how to verify that all tiers were evaluated during the application process.
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