The Medicare Savings Programs in Texas are four state-run programs that pay some or all of your Medicare premiums and, in one case, your deductibles and copays too. The Texas Health and Human Services Commission (HHSC) administers them, and eligibility comes down to your monthly income and countable resources. The most valuable of the four, the Qualified Medicare Beneficiary (QMB) program, covers your Part B premium of $202.90 per month in 2026 plus all Medicare cost-sharing on covered services.1Texas Health and Human Services. Q-1000, Medicare Savings Programs Overview2Medicare. Medicare Savings Programs
The Four Programs and What They Pay
Which program fits you depends mostly on your income. The higher the income tier, the less the program covers.
- Qualified Medicare Beneficiary (QMB). Pays your Part B premium, all Medicare deductibles, coinsurance, and copays. If you don’t get premium-free Part A, QMB pays that premium too.2Medicare. Medicare Savings Programs
- Specified Low-Income Medicare Beneficiary (SLMB). Pays your Part B premium only. Requires both Part A and Part B.2Medicare. Medicare Savings Programs
- Qualifying Individual (QI). Also pays your Part B premium only. Requires both Part A and Part B, and you cannot already be on Medicaid.3Texas Health and Human Services. Appendix IX, Medicare Savings Program Information
- Qualified Disabled and Working Individuals (QDWI). Pays the Part A premium for people under 65 who have a disability, returned to work, and lost premium-free Part A as a result. You cannot be on Medicaid.2Medicare. Medicare Savings Programs
2026 Income Limits
Income limits track the federal poverty level and update each year. The 2026 figures below apply in Texas.4U.S. Department of Health and Human Services. 2026 Poverty Guidelines – 48 Contiguous States HHSC also applies a $20 monthly income disregard, so you can earn slightly more than the stated limit and still qualify.
QMB (up to 100% of FPL)
SLMB (above QMB, below 120% of FPL)
- Individual: $1,330.01 to less than $1,596 per month
- Couple: $1,804.01 to less than $2,164 per month5Texas Health and Human Services. Medicare
QI (at least 120%, less than 135% of FPL)
- Individual: $1,596 to less than $1,796 per month
- Couple: $2,164 to less than $2,435 per month5Texas Health and Human Services. Medicare
QDWI (up to 200% of FPL)
2026 Resource Limits
HHSC also looks at what you own. For QMB, SLMB, and QI in 2026, countable resources cannot exceed $9,950 for an individual or $14,910 for a couple.6Texas Health and Human Services. Q-1300, MSP Resource Limits QDWI is stricter: $4,000 for an individual, $6,000 for a couple.3Texas Health and Human Services. Appendix IX, Medicare Savings Program Information
Countable resources include bank accounts, certificates of deposit, stocks, and bonds. Your principal residence in Texas, one car, and personal belongings generally don’t count.3Texas Health and Human Services. Appendix IX, Medicare Savings Program Information
Other Eligibility Requirements
- You must be entitled to Medicare Part A or enrolled in Part B for immunosuppressive drug coverage (Part B-ID). Kidney transplant recipients who kept only Part B-ID are still eligible to apply.3Texas Health and Human Services. Appendix IX, Medicare Savings Program Information
- You must be a Texas resident.
- QI applicants cannot already be receiving Medicaid.
- QDWI applicants must be under 65 and not receiving Medicaid.3Texas Health and Human Services. Appendix IX, Medicare Savings Program Information
If You Have QMB, Providers Cannot Bill You for Cost-Sharing
Federal law bars doctors, hospitals, and other Medicare providers from billing QMB enrollees for deductibles, coinsurance, or copays on Medicare-covered services.7Centers for Medicare & Medicaid Services (CMS). Reminder of Prohibition on Billing Qualified Medicare Beneficiaries Some providers send bills anyway because their systems don’t flag QMB status. If that happens, tell the provider you’re in QMB and cannot be charged. If the bills continue, call 1-800-MEDICARE (1-800-633-4227). Medicare can confirm your status with the provider and request a refund of anything you already paid.
Extra Help for Prescription Drugs
Approval for any Medicare Savings Program automatically enrolls you in Extra Help, which lowers Part D drug costs.8Medicare. Medicare’s Extra Help Program You don’t file a separate application. Medicare mails a purple Deemed Status Notice, and if you’re not already in a Part D plan, Medicare enrolls you in one.
In 2026, Extra Help means a $0 monthly plan premium, a $0 annual deductible, generics at up to $5.10 per prescription, and brand-name drugs at up to $12.65 per prescription. Once your total drug costs reach $2,100 in the year, covered drugs cost $0. If you have QMB plus full Medicaid, copays drop to no more than $4.90 per covered drug.9Medicare. Help With Drug Costs
How to Apply
Apply using Form H1200, Application for Assistance – Your Texas Benefits.10Texas Health and Human Services. Form H1200, Application for Assistance – Your Texas Benefits You can download it from Your Texas Benefits, pick it up at a local HHSC office, or request one by mail. Submit online through the Your Texas Benefits portal, by mail, or in person.
Before you start, pull together:
- Proof of identity and Texas residency
- Your Medicare card
- Income records: Social Security benefit statements, pension letters, pay stubs
- Bank and investment statements showing current resources
Free help with the application is available through the Texas Health Information, Counseling and Advocacy Program at 800-252-9240.5Texas Health and Human Services. Medicare
After You Apply
HHSC has 45 days to decide if you’re 65 or older or already have a Social Security disability determination, and 90 days if HHSC has to make the disability determination itself.11Texas Health and Human Services. B-6400, Processing Deadlines Respond quickly to any request for documents so you don’t stretch the timeline.
QMB coverage begins the first day of the month after HHSC has everything it needs. SLMB and QI can be retroactive up to three months before your application date if you were eligible during those months, which can mean reimbursement of Part B premiums you paid out of pocket.
You’ll get a decision notice by mail. Denials can be appealed through HHSC.12Texas Health and Human Services. C-6100, Appeals If the denial rests on a Social Security decision, appeal to SSA instead.
Renewals and Reporting Changes
MSP eligibility is not permanent. You recertify every year, and HHSC will usually send a renewal notice by mail. If you don’t get one, contact your local HHSC office. Missing the paperwork can end your benefits even when nothing about your finances has changed.
Between renewals, report significant changes in income or resources promptly. A new pension, an inheritance, or a change in household size can shift your eligibility, and unreported changes discovered later can trigger termination and overpayment recovery.