Need help affording Medicare in Texas? Discover if one of Texas’ four Medicare Savings Programs could help you pay for Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments.
Do you need help paying your Texas Medicare premiums? If you are eligible, a Texas Medicare Savings Program (MSP) might be able to help. Medicaid administers Medicare Savings Programs to help people with limited income and resources. These programs help those who qualify to afford Medicare in Texas.
You could get help paying your Medicare premiums if you qualify, including Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments.
The Texas Health and Human Services Commission (HHSC) manages four Medicare Savings Programs. Each program has a different income eligibility limitation, but the maximum accessible financial resources are nearly identical. Continue reading to see if you qualify for one of these programs:
For three of the four programs, the financial resources required are consistent. You should have limited financial resources to qualify for the QMB, SLMB, or QI program.
This means that when you add up all of your resources as an individual, in 2025, those should value no more than $9,430. As a married couple, your maximum countable resources should be $14,130.
Agent tip:
“In 2025, if you have more than $9,430 in financial resources, or $14,130 as a married couple, you may not qualify for any Medicare Savings Program.“
The QDWI has even more stringent financial resource requirements. The maximum financial resources for an individual are $4,000 and $6,000 for a couple.
If you meet these financial resource requirements, continue reading to see if you qualify for one of Texas’s four Medicare Savings Programs.
Do you want expert advice from a local agent or help applying for a Medicare Savings Program in Texas? Call (623) 223-8884 or find your plan online now.
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Local, licensed insurance agents with 25+ years of experienceThe Qualified Medicare Beneficiary (QMB) Program could pay for Part A & Part B premiums, deductibles, and coinsurance if you are entitled to Medicare Part A and meet income and financial resource requirements.
As a QMB, you do not receive standard state Medicaid benefits. Instead, you would receive a QMB identification card to show your medical providers. This card would be provided by the Texas Health and Human Services Commission (HHSC). Your QMB eligibility would begin on the first day of the month after you are certified for QMB benefits.
To be eligible for the Qualified Medicare Beneficiary Program, you must be eligible for Medicare Part A and meet income & financial resource requirements. If eligible, benefits would go into effect the first of the month following the month eligibility is documented.
Your maximum gross monthly income must be equal to or less than the limits set for individuals or couples. In 2025, the maximum gross income for an individual in Texas is $1,275, and for a couple, it’s $1,724.
If you and your spouse are applying for QMB, you should use the maximum gross monthly income limit for a couple. If only one of you is eligible for QMB, use the individual income limit to see whether you’re qualified as an individual.
What should you consider as income?
To qualify for the QMB program, you must have limited financial resources. This means that when you add up all of your resources as an individual, those should be valued no more than $9,430 in 2025. As a couple, your maximum countable resources should be $14,130.
See the top of this article for “Maximum Financial Resources” to see what should be included and excluded when accounting for your financial resources.
Free, unbiased serviceCompare all major plans and carriers Local, licensed insurance agents with 25+ years of experienceIf eligible, the Specified Low-Income Medicare Beneficiary (SLMB) Program will pay for your Medicare Part B premiums. If you receive Medicaid, you may also receive SLMB benefits. However, if you are SLMB-eligible, you will not get regular Medicaid benefits or a monthly medical identification card.
Your SLMB eligibility will begin the month of application, and if you meet all the criteria, medical coverage is eligible for three months before application.
The requirements for SLMB eligibility are similar to those of the Qualified Medicare Beneficiary (QMB) Program, but there is one difference. You must have an income higher than 100% but less than 120% of the Federal Poverty Level. Federal Poverty Level limits are updated annually by the Census Bureau.
To be eligible for the Specified Low-Income Medicare Beneficiary (SLMB) Program, you must be entitled to Medicare Part A, meet income requirements, and have limited financial resources.
Are you wondering what the maximum gross monthly income is for those greater than 100% but less than 120% of the poverty level? As an individual, in 2025, you’d need a monthly maximum income of $1,526. As a couple, your monthly income must be at most $2,064.
You must use the couple’s monthly income range if you and your spouse apply for the SLMB program. However, if only one of you is eligible, use the individual monthly income range to determine your eligibility separately.
What should you consider as income?
You need limited financial resources to qualify for the SLMB program. This means that when you add up all of your resources as an individual, those should be valued no more than $9,430. As a couple, your maximum countable resources should be $14,130.
See the top of this article for “Maximum Financial Resources” to see what should be included and excluded when accounting for your financial resources.
Free, unbiased serviceCompare all major plans and carriers Local, licensed insurance agents with 25+ years of experienceThe Qualifying Individual (QI) Program will cover your Medicare Part B premiums if you meet eligibility requirements. You cannot be eligible to receive regular Medicaid and QI program coverage simultaneously. If you are QI-eligible, you will not get regular Medicaid benefits or a medical identification card.
To qualify for the Qualifying Individual Program, you must be eligible for Medicare Part A and meet income and financial resource requirements.
To be eligible for the Qualifying Individual Program, you must have an income of at least 121% but less than 135% of the federal poverty level. Federal Poverty Level limits are updated annually by the Census Bureau.
Eligibility for QI coverage is decided for each calendar year, and your eligibility may begin the month that you apply for coverage. You are eligible for three months prior medical coverage under the QI program if you meet all the criteria. However, the three-month prior period cannot be extended back to the previous calendar year.
Are you wondering what the maximum gross monthly income is for those greater than 121% but less than 135% of the poverty level is? If you’re an individual, your monthly maximum income is $1,715. If you and your spouse need help, you should have a maximum monthly income of $2,320.
You must use the couple’s monthly income range if you and your spouse are applying for the Qualifying Individual Program. But if only one of you is eligible, use the individual monthly income range to see if you’re eligible on your own.
To qualify for the QI program, you must have limited financial resources. This means that when you add up all of your resources as an individual, those should be valued no more than $9,430. As a couple, your maximum countable resources should be $14,130.
See the top of this article for “Maximum Financial Resources” to see what should be included and excluded when accounting for your financial resources.
Unsure which Medicare Savings Program you’re eligible for—or which to apply to? Speak with a local agent who can guide you through your choices. Call (623) 223-8884 or review your plan options online.
Free, unbiased serviceCompare all major plans and carriers Local, licensed insurance agents with 25+ years of experienceThe Qualified Disabled and Working Individual (QDWP) Program will pay for only your Medicare Part A premium if you are eligible. You cannot qualify for regular Medicaid and QDWI at the same time.
To be eligible for the Qualified Disabled and Working Individual Program, you must be under 65, entitled to benefits under Medicare Part A, not otherwise eligible for Medicaid, and meet income and financial resource requirements. If eligible, benefits would go into effect 3 months retroactively from the date of application if you meet eligibility criteria during those months.
If you are a couple applying QDWI, your monthly income should be a maximum of $6,899. For an individual, the maximum gross income is $5,105. Income must be less than or equal to the maximum gross income limits.
If you and your spouse are applying for the Qualified Disabled and Working Individual Program, you must use the couple’s monthly income range. But if only one of you is eligible for the program, use the individual monthly income range to see if you’re eligible.
What should you consider as income?
To qualify for the QDWI program, you must have limited financial resources. This means that when you add up all of your resources as an individual, they should be valued at no more than $4,000. As a couple, the maximum resources are $6,000.
See the top of this article for “Maximum Financial Resources” to see what should be included and excluded when accounting for your financial resources.
Medicare Savings Programs help people who are already on Medicare. Not yet on Medicare? Enroll in Medicare Part A and apply for a Texas Medicare Savings Program. If you’re not enrolled in Part A yet, Connie Health can help by calling (623) 223-8884.
If you are enrolled in Medicare Part A, a Connie Health agent can help you complete an Application for Benefits with the Texas Health and Human Services Commission. Call now to speak with a local licensed agent: (623) 223-8884.
You may be eligible even if your income or financial resources are higher than the amounts listed in this article.
Reach out to your local Medicare agent to discuss your eligibility and any questions you may have or to assist you in applying for benefits. Call (623) 223-8884 or review your Medicare plan options online.
Free, unbiased serviceCompare all major plans and carriers Local, licensed insurance agents with 25+ years of experience
Texas Medicare Savings Programs help those who qualify to afford Medicare in Texas.
You could get help paying your Medicare premiums if you qualify, including Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments.
There are four Medicare Savings Programs managed by the Texas Health and Human Services Commission: The Qualified Medicare Beneficiary (QMB) Program, the Specified Low-Income Medicare Beneficiary (SLMB) Program, the Qualified Individual (QI) Program, and the Qualified Disabled and Working Individual (QDWI) Program.
Each program has a different income eligibility limitation, but the maximum accessible financial resources are nearly identical. Three of the four programs require that in 2025, an individual should have no more than $9,430 and a married couple should have no more than $14,130 in financial resources.
If you fit this financial resources limitation, you could qualify for a Medicare Savings Program in Texas. A local licensed Connie Health agent could help you determine your eligibility. Call (623) 223-8884 to assess your eligibility.
To apply for the Medicare Savings Program in Texas, you must first be enrolled in Medicare Part A.
Connie Health can walk you through the process if you’re not yet enrolled. If you are enrolled in Part A, Connie Health can help you complete an Application for Benefits with the Texas Health and Human Services Commission.
Even if your income or financial resources are higher than required, you may be eligible for one of four Medicare Savings Programs in Texas.
To learn if you qualify for a Medicare Savings Program in Texas, call (623) 223-8884 and speak with a local licensed Connie Health agent.
Read more by Jasmine Alberto
I am a Spanish-speaking Texas Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2007. I am on the the Advisory Committee for Foster Grandparents, Senior Companions, and RSVP Houston. I enjoy traveling, a backyard BBQ, and volunteering in my community.
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