Tennessee SLMB and QI: What These Medicare Savings Programs Cover and Who Qualifies

Most people searching for Medicare cost help in Tennessee hear about QMB first. It gets the attention because it covers the most. But two other Medicare Savings Programs — SLMB and QI — quietly save thousands of Tennessee seniors from losing $202.90 every month to a Part B premium they cannot afford.

If your parent's income is too high for QMB but they are still struggling to cover Medicare costs, SLMB or QI may be the answer.

What SLMB and QI Actually Pay For

Both programs do one thing: they pay the standard Medicare Part B monthly premium, which is $202.90 in 2026. That puts $2,434.80 back into a senior's pocket each year.

Neither SLMB nor QI covers Part A premiums, Medicare deductibles, copays, or coinsurance. Those cost-sharing protections belong exclusively to QMB. But for someone on a fixed Social Security check, getting that $202.90 monthly deduction eliminated is significant.

Both programs also confer deemed eligibility for Part D Extra Help, which covers most prescription drug costs. Your parent does not need to apply separately — TennCare's approval automatically qualifies them.

2026 Income and Asset Limits

TennCare applies a $20 monthly unearned income disregard before comparing income against Federal Poverty Level thresholds.

SLMB (above 100% through 120% FPL):

• Individual: up to $1,616/month gross income
• Couple: up to $2,184/month gross income

QI (above 120% through 135% FPL):

• Individual: up to $1,816/month gross income
• Couple: up to $2,455/month gross income

Asset limits for both:

• Individual: $9,950
• Couple: $14,910

Assets exclude the primary home if the applicant lives there or intends to return, one vehicle, personal belongings, and designated burial funds up to $1,500 per person, reduced by excluded life insurance cash value.

TennCare uses gross Social Security — the amount before the Part B premium is deducted — when calculating income. If your parent's net deposit is $1,413.10, their gross is actually $1,616.00, which matters for determining which tier they fall into.

The Key Difference Between SLMB and QI

SLMB is a standard Medicaid entitlement. If your parent meets the income and asset criteria, TennCare must approve them. There is no funding cap.

QI works differently. It runs on capped annual federal funding, so enrollment is first-come, first-served and approval depends on available funds. Existing QI enrollees receive priority during annual redetermination.

One other distinction: a person receiving Medicaid under any other TennCare category cannot simultaneously receive QI. SLMB has no such restriction.

How to Apply

Applications go through TennCare Connect — the same process for all three MSP tiers:

1. Online at tenncareconnect.tn.gov
2. Phone at 1-855-259-0701 (TTY: 1-800-848-0298)
3. Paper mailed to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240
4. In person at any county DHS office

TennCare's electronic data matching often handles verification automatically. If it cannot, you will receive an Information Request Notice with a 10–15 day deadline to submit bank statements, Social Security Award Letters, and proof of Medicare enrollment.

Processing typically takes 20–40 days. SLMB and QI coverage can be applied retroactively up to three months before the application month — a meaningful advantage over QMB, which starts only on the first of the month after approval.

What Happens After Approval

TennCare sends a buy-in record to CMS, which tells Social Security to stop deducting the Part B premium. This inter-agency process takes 60–90 days, so your parent may see one or two more deductions before the adjustment hits. Social Security issues a lump-sum refund for any premiums deducted after coverage started.

The Tennessee Medicare Savings Programs & Extra Help Guide walks through the full application process, income calculation worksheets, and what to do if the premium deduction does not stop on schedule.

SLMB and QI Do Not Trigger Estate Recovery

Neither SLMB nor QI benefits are subject to Medicaid estate recovery. TennCare cannot file a claim against a beneficiary's home or estate based solely on Part B premium payments made through these programs. Estate recovery applies only to long-term care services through TennCare CHOICES.

If your parent falls in the income range between QMB and 135% FPL, one of these two programs can eliminate their Part B premium and unlock prescription drug savings — with no estate-recovery claim based on MSP benefits alone. The complete guide includes worked examples for both tiers so you can see exactly where your parent falls.

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