What each Texas program pays
| Program | What it pays |
|---|---|
| Qualified Medicare Beneficiary (QMB) | Part A and Part B premiums, plus Medicare deductibles and coinsurance |
| Specified Low-Income Medicare Beneficiary (SLMB) | Part B premium |
| Qualifying Individual (QI-1) | Part B premium (not available if you get other Medicaid benefits) |
| Qualified Disabled and Working Individual (QDWI) | Part A premium, for people under 65 with a disability who returned to work |
QMB is the most valuable. Medicare.gov says that with QMB, Medicare providers aren't allowed to bill you for services and items Medicare covers. If a doctor or hospital bills you anyway, show your QMB proof and call 1-800-MEDICARE.
Who qualifies in Texas?
You must have Medicare Part A (or be able to get it) and meet HHSC's income and resource limits. Texas lists its limits as gross monthly income, which is why they can look a little different from the national figures on Medicare.gov. Resources for QMB, SLMB and QI are limited to $9,950 for one person or $14,910 for a couple in 2026; QDWI has its own lower limits. Check the current figures in HHSC's Appendix IX, or try our Medicare Savings Programs calculator.
How do I apply?
- Online at YourTexasBenefits.com, HHSC's application site.
- By phone by calling 2-1-1 and asking about HHSC benefits.
- In person at an HHSC benefits office.
Have your Medicare card, Social Security award letter, proof of income and recent bank statements ready. Medicare itself is handled by Social Security, so you need Medicare before an MSP can pay for it.
Tip: An MSP also opens a Special Enrollment Period. Medicare.gov says people with Medicaid or Extra Help can change Part D plans once a month. See can I switch Medicare Advantage plans after open enrollment.
Get help
A licensed insurance agent with Benefits Life can explain how a Medicare Savings Program fits with your Medicare plan and compare plans from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. See Medicare Savings Programs in Texas.
Related questions
What is STAR+PLUS?
Texas Medicaid for adults 65+ and people with disabilities.
Can I have STAR+PLUS and Medicare Advantage?
How the two fit together.
Medicare phone numbers in Texas
Official numbers for Medicare and HHSC.
Sources
- Texas HHSC — MEPD Handbook, Appendix IX, Medicare Savings Program information
- Texas HHSC — MEPD Handbook, Q-1000, Medicare Savings Programs overview
- Medicare.gov — Medicare Savings Programs
- Medicare.gov — Special Enrollment Periods
- Your Texas Benefits (HHSC)
Frequently asked questions
How much is the Part B premium these programs pay?
The standard Part B premium in 2026 is $202.90 a month. If you qualify for QMB, SLMB or QI, the State of Texas pays it for you.
What are the Texas income and resource limits?
HHSC posts the current monthly income limits in its Medicaid for the Elderly and People with Disabilities Handbook, Appendix IX, and updates them each year. For QMB, SLMB and QI, the 2026 resource limit is $9,950 for one person and $14,910 for a couple. Medicare.gov says to apply even if you think you're over the limits.
Do I also get help with drug costs?
Yes. Medicare.gov says people in QMB, SLMB or QI also get Extra Help with Part D drug costs.
Does a Medicare Savings Program give me full Texas Medicaid?
No. QMB, SLMB, QI and QDWI pay Medicare costs only; HHSC's handbook says they don't include regular Medicaid benefits. Some people qualify for full Medicaid as well, often through STAR+PLUS.
Medicare in your Texas county
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