How to Apply for QMB in Texas: Eligibility, Documents, and Filing

To apply for QMB in Texas, submit Form H1200 to the Texas Health and Human Services Commission (HHSC) online at YourTexasBenefits.com, by mail to PO Box 14600, Midland, TX 79711-4600, or in person at a local HHSC office, along with proof of your Medicare enrollment, identity, Texas residency, citizenship, income, and resources.¹ You’ll qualify for the Qualified Medicare Beneficiary program if your monthly income is at or below $1,305 for an individual or $1,763 for a couple, and your countable resources are at or below $9,950 individually or $14,910 as a couple as of January 1, 2026.² Once approved, Texas pays your Medicare Part A and B premiums, deductibles, coinsurance, and copayments for Medicare-covered services.³

Who Qualifies

HHSC checks five things: Medicare enrollment, Texas residency, citizenship or eligible immigration status, income, and resources.² You must be enrolled in Medicare Part A (or Part B for immunosuppressive drug coverage) and live in Texas. A Medicare card, U.S. passport, or birth certificate can prove citizenship.⁴

Income

Your gross monthly income cannot exceed 100 percent of the federal poverty level, which for 2026 is $1,305 for a single person and $1,763 for a married couple.² HHSC counts Social Security, pensions, wages, interest, and other regular payments. These limits update each year with the federal poverty guidelines.

Resources

Countable resources cannot exceed $9,950 for an individual or $14,910 for a couple as of January 2026.⁵ Bank accounts, certificates of deposit, stocks, bonds, IRAs, and real property beyond your home count. Your Texas homestead, one vehicle, burial plots for you and your spouse, up to $1,500 in burial funds, and small life insurance policies with a combined face value of $1,500 or less do not.²

Documents to Gather Before You Start

Having everything ready prevents delays. You’ll use Form H1200, available online through YourTexasBenefits.com, by download from the HHSC website, by calling 2-1-1, or from a local HHSC office.¹ Collect the following:

A Texas driver’s license or Department of Public Safety ID card for identity.
Your Medicare card showing your claim number.
Proof of citizenship: U.S. passport, birth certificate, Certificate of Naturalization, or Medicare card.
Proof of Texas residency: a utility bill, rent receipt, mortgage statement, or Texas driver’s license.
Proof of income: Social Security award letters, pension statements, recent pay stubs, or your most recent tax return.
Proof of resources: current statements for every bank account, plus statements or certificates for stocks, bonds, annuities, and trusts.

If you’re married, gather the same documents for your spouse even if only one of you is applying. HHSC looks at household income and resources for couples.⁴

Three Ways to Submit Your Application

Choose the method that fits you best. Keep copies of everything, whichever route you take.

Online: create an account at YourTexasBenefits.com, complete the application, and upload your documents. The account saves your progress if you need to stop and come back.⁶
By mail: send Form H1200 and copies of your supporting documents to HHSC, PO Box 14600, Midland, TX 79711-4600. Certified mail with a return receipt gives you proof of the delivery date.
In person: bring your packet to a local HHSC office and ask for a receipt. Call 2-1-1 or 1-877-541-7905 to find the nearest office.¹

What Happens After You Apply

QMB is processed under the Medicaid for the Elderly and People with Disabilities category. HHSC takes up to 45 days for a standard application and up to 90 days if a disability determination is involved.⁷ Some cases run longer when extra verification is needed. A caseworker may contact you for clarification or missing documents. Respond quickly, because any delay on your end extends the total timeline.

You’ll get a written decision by mail. If approved, benefits generally begin the first day of the month after HHSC certifies your eligibility. One thing to know: QMB does not reimburse Part B premiums you already paid before your approval date. Going forward, the state takes over those payments, but the months your application was pending are not refunded.

Approval also automatically qualifies you for Extra Help, the federal program that lowers Medicare Part D prescription drug costs to no more than $12.65 per covered prescription in 2026.⁸ You don’t file a separate Extra Help application.

If You’re Denied or Your Income Is Too High

A denial arrives as a Notice of Case Action explaining exactly why HHSC turned you down. Common reasons include income or resources slightly over the limit, missing documents, or a problem verifying Medicare Part A enrollment. Read the notice carefully; sometimes the fix is as simple as sending a bank statement you forgot to include.

If you believe the denial was wrong, you have 90 days from the date on the notice to request a fair hearing.⁹ Request it in writing, by calling 2-1-1, or in person at your local HHSC office. You’ll be able to present evidence and explain why you meet the requirements. You can also reapply at any time if your finances change.

If your income is over the QMB limit, Texas has two other Medicare Savings Programs that use the same application form and the same resource limits ($9,950/$14,910). Both automatically qualify you for Extra Help.⁸

Specified Low-Income Medicare Beneficiary (SLMB) covers your Part B premium. The 2026 income limit is $1,616 per month for an individual or $2,184 for a couple.
Qualifying Individual (QI) also covers your Part B premium. The 2026 income limit is $1,816 per month for an individual or $2,455 for a couple.

You don’t have to choose which program to apply for. HHSC evaluates you for the one that fits.

Keeping Your Benefits After Approval

HHSC reviews your eligibility every year. Around the ninth month of your certification period, it checks electronic data sources to see if you still qualify. If the system verifies eligibility automatically, your benefits renew with no action from you.¹⁰

If more information is needed, you’ll get a renewal form in the mail with 30 days to return it. You can respond through YourTexasBenefits.com, by mail, by fax, or at an HHSC office. Missing that 30-day window is where people lose coverage they still qualify for. Without a response, HHSC terminates your eligibility at the end of your 12th certification month.¹⁰ Between renewals, report changes to your income, resources, address, or household size through YourTexasBenefits.com or by calling 2-1-1.

One Concern That Doesn’t Apply

Some people put off applying because they worry the state will pursue their estate after they die. Federal law specifically exempts Medicare Savings Program benefits, including QMB, from Medicaid estate recovery.¹¹ The premiums and cost-sharing QMB pays on your behalf will not result in a claim against your home or other assets.

1
yourtexasbenefits.com. How to Apply: Your Texas Benefits
2
Texas Health and Human Services. Appendix IX, Medicare Savings Program Information
3
Texas Health and Human Services. Q-2000, Qualified Medicare Beneficiaries
4
Your Texas Benefits. Documents To Send With Your Application
5
Texas Health and Human Services. Appendix XI, Income and Resource Limits
6
Texas Health and Human Services Commission. Your Texas Benefits
7
Texas Health and Human Services. Appendix XIX, Case Management Time Frames
8
Medicare. Medicare Savings Programs
9
Texas Health and Human Services. Fair and Fraud Hearings
10
Texas Health and Human Services. B-8400, Procedures for Redetermining Eligibility
11
Medicaid.gov. Estate Recovery