0870.000.00 Specified Low-Income Medicare Beneficiaries (SLMB1) and Qualifying Individuals (SLMB2)

0870.020.15 IMU5 Completion

Completion of the IMU5 for the SLMB program follows QMB instructions in the following situations:

  • When the entry in Field 13M1, QMB/SLMB Eligibility is “L”, “2”, “3” or “Q”, an entry is required in Field 13M2, QMB/SLMB Eligibility Date. Failure to meet these requirements will result in an online edit.
    • SLMB approvals (type of assistance “L” or in combination with any other type of assistance) require an entry in Field 13I, Social Security Claim Number. No entry or an invalid configuration causes an edit.
    • “L” type of assistance cases must have an expense figure in Field 33 equal to one of the SLMB standards.
    • Net income figures entered in Field 34 for SLMB cases may not be less than the QMB or lower SLMB income standard for the same household size. Entry of a figure less than the QMB or lower SLMB income standard used will prompt an edit stating “INCOME LESS THAN QMB OR SLMB STANDARD”. If the net income in Field 34 exceeds the income standard for household size an edit occurs stating “INCOME EXCEEDS SLMB STANDARD”. Take action to review the case for SLMB “2” or “3” eligibility before rejecting the application.
    • Approvals for SLMB do not allow an entry in Field 13E, TXIX Eligibility Date, or Field 13G, Level of Care.