Texas Medicare Savings Programs 2026: QMB, SLMB & QI

If you have Medicare and live on a limited income in Texas, a Medicare Savings Program can erase your $202.90 monthly Part B premium.1

The most complete tier, QMB, also wipes out your Medicare deductibles and copays. All three programs run through Texas Medicaid, and enrolling in any one of them automatically opens the door to Part D drug-cost help.

What Are Texas Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered benefits that pay some or all of a low-income Medicare beneficiary's premiums and cost-sharing. QMB, SLMB, and QI are mandatory federal eligibility groups, so Texas is required to offer all three.

Texas runs the programs through the Texas Health and Human Services Commission (HHSC), which decides financial eligibility under its Medicaid for the Elderly and People with Disabilities (MEPD) rules. Texas uses the standard federal income tiers tied to the Federal Poverty Level (FPL) and the asset-tested methodology of Supplemental Security Income (SSI), so a resource (asset) test applies here.2

An MSP is separate from full Medicaid: you can qualify for help with your Medicare costs without qualifying for the full Medicaid benefit package, and the income and resource limits are far more generous than the ones for nursing-home Medicaid.

Who Qualifies for a Texas Medicare Savings Program in 2026?

Which program you land in depends on your monthly income. All three share the same resource test.

These bands reflect 100% of the Federal Poverty Level for QMB, 100 to 120% for SLMB, and 120 to 135% for QI, with the standard $20 monthly income disregard already built in. The resource (asset) limit for all three is $9,950 for a single person and $14,910 for a couple.2

What counts as a resource, and what does not. The resource test counts less than most people expect, because the largest assets are excluded. Your primary home (regardless of value), one vehicle, household goods, personal effects, and prepaid burial arrangements do not count. What does count is money in checking and savings, certificates of deposit, stocks and bonds, and a second home or second car. Someone who owns a paid-off house worth several hundred thousand dollars can still qualify for QMB, as long as their countable assets stay under the limit. That $9,950 ceiling is nearly five times the $2,000 resource limit Texas uses for nursing-home and waiver Medicaid, so many people who are turned away from long-term-care Medicaid still qualify here.2,4

How Texas counts your income. Medicare Savings Programs do not use the MAGI rules that regular Medicaid uses. They use the SSI-related methodology, which sets aside part of your income before comparing it to the limit. The published limits already build in the standard $20-a-month general income disregard, and if you work, the SSI rules leave out even more of your earnings, so your gross wages overstate what actually counts.2 If your income looks a little too high, apply anyway. For someone stretching a fixed Social Security check, having Texas cover that premium can be the difference between filling a prescription and skipping it, and the disregards often bring a borderline applicant under the line.

What Does Each Program Pay?

QMB: Full Premiums Plus All Cost-Sharing

QMB is the most complete program. For a single Texan with income at or below $1,350 a month, it covers:2

• The full Medicare Part B premium, $202.90 a month in 2026
• The Medicare Part B deductible, $283 in 2026
• The Medicare Part A hospital deductible, $1,736 per benefit period in 20261
• The Part A premium, which most people already receive at no cost after 40 quarters of work
• All Medicare coinsurance and copays on covered services

The Part B premium alone is worth about $2,435 a year ($202.90 a month over 12 months), before you count the deductibles and coinsurance QMB also erases.1 What QMB does not cover is care Medicare itself never pays for, such as the custodial portion of long-term nursing-home care.

SLMB and QI: The Part B Premium

SLMB and QI each cover one thing: the Medicare Part B premium, $202.90 a month in 2026, worth about $2,435 a year.1 They do not touch deductibles or copays, but for someone with few medical bills, erasing the Part B premium is the savings that matters most. SLMB covers income above the QMB line up to $1,616 a month ($2,184 for a couple); QI covers income above the SLMB line up to $1,816 a month ($2,455 for a couple).2

Two things set QI apart. It is funded by a capped federal allotment, so Texas enrolls people first-come, first-served and cannot guarantee a spot the way it must for QMB and SLMB. People enrolled the prior year get priority, so if you are close to the QI line, apply early in the year. And you cannot hold QI and full Texas Medicaid at the same time; if you qualify for full Medicaid, you receive your Medicare cost-sharing help through that instead.3

Billed for a Copay on QMB? You Do Not Owe It

Federal law bars every Medicare provider from billing a QMB enrollee for Medicare deductibles, coinsurance, or copays, under any circumstances. This holds whether you have Original Medicare or a Medicare Advantage plan, and whether or not the provider takes Texas Medicaid.3 For a retiree living check to check, that protection can be a real weight off: even a wrongly issued copay bill is not a debt you have to pay.

If a hospital, doctor, or other provider sends you a cost-sharing bill:

• Tell them you are a QMB enrollee and that federal law prohibits the charge.
• Show your HHSC eligibility notice or your Medicare card.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact Texas HICAP, the state's free Medicare counseling program, at 1-877-839-2675 for help disputing the bill.5

A provider who wrongly billed a QMB enrollee must recall the bill and refund anything already collected.

Your MSP Automatically Unlocks Part D Extra Help

Enrolling in QMB, SLMB, or QI automatically qualifies you for the full Part D Extra Help benefit, also called the Low-Income Subsidy, with no separate application to the Social Security Administration.3 This is one of the most frequently missed benefits for Medicare beneficiaries in Texas.

In 2026, full Extra Help caps what you pay for any covered prescription at $12.65 per drug and eliminates the Part D premium and deductible for most enrollees.6 If you are not already in a Part D plan, Medicare assigns you to a benchmark plan with no monthly premium.

How to Apply for a Texas Medicare Savings Program

By law, HHSC must decide most Medicare Savings Program applications within 45 days, or within 90 days when eligibility rests on a disability.7 Enrollment renews once a year, and HHSC mails a renewal notice before your benefit period ends.

Learn More

Find personalized help applying for a Texas Medicare Savings Program at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.