SLMB and QI in West Virginia: Medicare Part B Premium Help Above the QMB Limit

What SLMB and QI Actually Do

Both SLMB (Specified Low-Income Medicare Beneficiary) and QI (Qualifying Individual) do the same thing: pay your monthly Medicare Part B premium. In 2026, that's $202.90/month — $2,434.80 per year that stops coming out of your Social Security check.

They don't cover deductibles, coinsurance, or copays the way QMB does. But for someone living on $1,500 or $1,700 a month, getting $202.90 back every month makes a real difference.

Both programs also automatically qualify you for full Extra Help with Part D drug costs. That means $0 annual deductible on your Part D plan, $0 premium on benchmark plans, and copays capped at $5.10 for generics and $12.65 for brand-name medications.

Income Limits for 2026

SLMB — income between 100% and 120% FPL:

• Single: $1,351–$1,616/month
• Couple: $1,825–$2,184/month

QI — income between 120% and 135% FPL:

• Single: $1,617–$1,816/month
• Couple: $2,185–$2,455/month

Both tiers use the same resource limits: $9,950 individual, $14,910 couple. The same exclusions apply — your primary home is excluded up to the $752,000 equity limit, one car is excluded regardless of value, and burial plots and irrevocable burial contracts don't count.

These income figures already include the $20 general disregard that caseworkers apply to unearned income. If your gross Social Security is $1,636, your countable income is $1,616 — right at the SLMB ceiling.

The Key Difference Between SLMB and QI

The main operational difference: SLMB is an open-ended federal entitlement. If you qualify, you get it. QI is funded through a capped annual federal grant, and West Virginia processes applications first-come, first-served. Priority goes to people who received QI the previous year.

In practice, QI funding in West Virginia has not run out in recent years. But there's no legal guarantee it won't — so the sooner you apply, the better.

One more QI rule: you can't receive QI while enrolled in any full Medicaid coverage group. If your circumstances change and you become eligible for full Medicaid, QI coverage closes.

Retroactive Coverage — SLMB and QI's Advantage Over QMB

Here's where SLMB and QI have an edge that QMB doesn't: retroactive coverage. Both programs can be backdated up to three calendar months before your application date, as long as you met all the financial and Medicare requirements during those months.

That means if you applied in October and qualified starting in July, West Virginia will reimburse three months of Part B premiums you already paid. QMB, by contrast, is strictly prospective — it can never be backdated, no matter how long you waited to apply.

After approval, it typically takes 60 to 90 days for the interagency exchange between DoHS, CMS, and SSA to process. Social Security may keep deducting Part B premiums during that window. Once the systems sync, SSA stops the deductions and sends a lump-sum reimbursement covering every month back to your effective date — including those retroactive months.

How to Apply

Same channels as all West Virginia MSPs: WV PATH online (wvpath.wv.gov), Form DFA-QSQ-1 by mail to your county DoHS office, or by phone at 1-877-716-1212. Processing takes up to 30 calendar days.

West Virginia's Income Maintenance Manual labels SLMB as "SLIMB" and QI as "QI-1" or "QIA" in its internal documentation. If your approval notice uses those terms, they're the same programs.

The West Virginia Medicare Savings Programs guide includes an income worksheet that shows exactly which tier you qualify for and how to calculate your countable income using West Virginia's rules.

See more West Virginia guides →