Texas Medicare Savings Programs (MSPs) pay Medicare premiums and, for the broadest tier, all Medicare deductibles and copays on behalf of people with limited income. Three programs cover different income bands, ranging from QMB at 100% of the Federal Poverty Level up to QI at 135% FPL. In 2026, a single person earning up to about $1,816 a month may qualify for some level of help.
What Are Medicare Savings Programs?
Medicare Savings Programs are a subset of Medicaid that specifically help people pay Medicare costs. They're distinct from full Medicaid: a person can qualify for an MSP without qualifying for the full Medicaid benefit package.
Texas administers three MSPs through the Texas Health and Human Services Commission (HHSC). Each has a different income band and a different scope of cost-sharing assistance.
For people who qualify for QMB, providers are prohibited from billing them Medicare cost-sharing under federal law. That protection is significant: even if a provider submits a bill for a copay, QMB enrollees are not legally obligated to pay it.
Program-by-Program Details
QMB: Qualified Medicare Beneficiary
QMB is the most protective of the three programs. It covers:
- Medicare Part A premium (if applicable)
- Medicare Part B premium ($185/month in 2026)
- Part A and Part B deductibles, coinsurance, and copays
2026 Income Limits (approximate)
The federal government sets QMB income limits at 100% of the Federal Poverty Level (FPL) plus a $20/month general income disregard.
- Individual: up to approximately $1,350/month
- Couple: up to approximately $1,824/month
These figures are based on the 2026 SSI Federal Benefit Rate and FPL thresholds. SSA.gov publishes updated figures each January.
What QMB does not cover: QMB pays Medicare cost-sharing, not services that Medicare doesn't cover at all. Long-term nursing-home care (the custodial, non-skilled portion) is not a Medicare benefit regardless of QMB status.
The no-billing protection: Under federal law, Medicare providers and suppliers cannot bill QMB enrollees for Medicare cost-sharing. If a provider attempts to collect a copay from a QMB enrollee, the enrollee can report this to the Centers for Medicare and Medicaid Services (CMS) or 1-800-MEDICARE.
SLMB: Specified Low-Income Medicare Beneficiary
SLMB pays only the Medicare Part B premium. In 2026, that premium is $185/month for most enrollees.
2026 Income Limits (approximate)
- Individual: up to approximately $1,616/month
- Couple: up to approximately $2,184/month
Income limits for SLMB are set at 120% of FPL. SLMB does not cover deductibles or copays.
QI: Qualifying Individual
QI also pays only the Medicare Part B premium. Income limits are higher than SLMB, set at 135% of FPL.
2026 Income Limits (approximate)
- Individual: up to approximately $1,816/month
- Couple: up to approximately $2,455/month
QI has a critical distinction: it is funded through an annual federal appropriation rather than as an entitlement. States enroll applicants on a first-come, first-served basis until the year's funding runs out. People who qualified the prior year are given priority for re-enrollment. If you're close to the QI income limit, apply early in the calendar year.
Asset Limits (2026)
All three programs share the same asset test:
- Individual: $9,950
- Couple: $14,910
Exempt assets include one primary home (regardless of value), one vehicle, household goods and personal effects, and burial funds up to certain limits. Retirement accounts may be treated differently depending on whether they're countable under HHSC rules.
The asset limits for MSPs are set by federal law and are significantly higher than the $2,000 Medicaid long-term care asset limit. Someone who doesn't qualify for nursing-home Medicaid because of assets may still qualify for QMB or SLMB.
The Extra Help / Low Income Subsidy Connection
People who qualify for a Medicare Savings Program automatically qualify for Extra Help (also called the Low Income Subsidy, or LIS) for Medicare Part D prescription drug costs. Extra Help reduces or eliminates Part D premiums, deductibles, and copays.
This connection is one of the most frequently missed financial benefits for Medicare beneficiaries in Texas. HHSC enrolls MSP recipients in Extra Help automatically; no separate Social Security Administration application is needed.
In 2026, full Extra Help is worth up to several thousand dollars per year for beneficiaries with high medication costs.
How to Apply for Texas Medicare Savings Programs
Texas MSP applications go through HHSC, not the Social Security Administration. Four ways to apply:
- Online: YourTexasBenefits.com
- By phone: Call 2-1-1 and ask about Medicaid for the Elderly and People with Disabilities (MEPD)
- In person: At any HHSC benefits office
- By mail: Download Form H1200 from hhs.texas.gov and mail to the HHSC processing center
HHSC has 45 days to make an eligibility decision for applicants 65 and older. Free application help is available from Area Agencies on Aging (1-800-252-9240) and Aging and Disability Resource Centers (1-855-937-2372).
Income Counting Rules
Not all income counts toward the MSP income test. Texas applies several standard disregards:
- General income disregard: $20/month is excluded from any income source.
- Earned income disregard: $65/month plus half of remaining earned income is excluded if the applicant has employment income.
- SSI income exclusions: Several other exclusions mirror SSI rules.
Social Security benefits, pension income, and interest/dividends all count as income after disregards. In-kind support (a family member paying rent or utilities) generally does not count.
If your gross monthly income looks above the limit, apply anyway. Disregards often bring the countable figure below the threshold.
| Program | Income Limit (Individual) | Income Limit (Couple) | What It Pays |
|---|---|---|---|
| QMB | ~$1,350/month | ~$1,824/month | Part A + Part B premiums; all Medicare deductibles, coinsurance, and copays |
| SLMB | ~$1,616/month | ~$2,184/month | Part B premium only ($185/month) |
| QI | ~$1,816/month | ~$2,455/month | Part B premium only; annual funding cap applies |
Frequently Asked Questions
Yes. People who qualify for both are called "dual eligibles." Full dual eligibility provides more comprehensive benefits than a Medicare Savings Program alone, including coverage for long-term nursing home and home care. If your income and assets fall within full Medicaid limits, apply for full Medicaid rather than just an MSP.
QMB enrollment changes who pays your Medicare cost-sharing, not what Medicare covers. You keep your same doctors and the same Medicare benefits. The difference is that HHSC (not you) pays the premiums, deductibles, and copays.
Texas MSP enrollees must renew their eligibility annually. HHSC sends a renewal notice roughly 60 days before the end of the benefit year. You can renew online through YourTexasBenefits.com or by calling 2-1-1.
HHSC looks at monthly income at the time of application. If your income varies, they typically average recent months or use the most recent month as a baseline, depending on the income type. If your income drops below the limit, you can apply or reapply at any time.
Learn More
- Texas Medicaid Eligibility and Income Limits
- How to Apply for Medicaid in Texas
- Personal Needs Allowance Explained
Find personalized help determining whether you qualify 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.