Texas Medicare Savings Program — QMB, SLMB, and QI Explained

What the Medicare Savings Programs Actually Do in Texas

Texas runs four Medicare Savings Programs through the Health and Human Services Commission (HHSC), and each one picks up a different slice of your parent's Medicare costs. The broadest tier — QMB (Qualified Medicare Beneficiary) — pays Part A and Part B premiums, deductibles, coinsurance, and copayments. SLMB and QI cover the Part B premium only. QDWI pays the Part A premium for under-65 disabled workers who went back to work.

The programs are administered by the Medicaid for the Elderly and People with Disabilities (MEPD) unit within HHSC. That's the same agency that handles Medicaid, but Medicare Savings Programs are a separate benefit: your parent doesn't get a Medicaid card, doesn't get full Medicaid services, and — critically — the state's Medicaid Estate Recovery Program (MERP) cannot touch their home or estate for MSP benefits.

2026 Income and Asset Limits

QMB, SLMB, and QI use the same asset ceiling of $9,950 for an individual and $14,910 for a couple (QDWI is lower: $4,000 / $6,000). Income limits for 2026:

• QMB: up to $1,350/month individual, $1,824/month couple
• SLMB: $1,350.01 to under $1,616/month individual, $1,824.01 to under $2,184/month couple
• QI: $1,616 to under $1,816/month individual, $2,184 to under $2,455/month couple
• QDWI: up to $2,660/month individual, $3,607/month couple

Texas applies a standard $20 monthly income disregard, so the effective gross income ceiling is $20 higher than the countable limit. Your parent's primary home, one vehicle, personal belongings, and up to $1,500 in designated burial funds are all excluded from the asset count.

What Each Tier Covers

QMB is the program families search for most. Once approved, your parent pays nothing for the Part B premium ($202.90/month in 2026), the Part A hospital deductible ($1,736 per benefit period), or the 20% coinsurance on outpatient services. Providers are legally barred from billing QMB recipients for any of this.

SLMB and QI both cover the Part B premium only. The practical difference is funding: QI runs on a capped federal block grant, meaning enrollment is first-come, first-served and requires annual re-application. SLMB is an entitlement — if your parent qualifies, they get in.

Any MSP tier also triggers automatic enrollment in Extra Help (the Part D Low-Income Subsidy), which eliminates or dramatically reduces prescription drug costs.

How to Apply

Applications go through HHSC, not through Medicare or Social Security. The fastest route is the online portal at YourTexasBenefits.com. For an MSP-only application, the streamlined Form H1200-EZ is the right form — not the full 19-page Form H1200, which asks for years of asset transfer history that MSP applicants don't need to provide.

Your parent can also apply by calling 2-1-1 (select Option 2 for the MEPD unit), through the Your Texas Benefits mobile app, or by mailing Form H1200-EZ to PO Box 149024, Austin, TX 78714-9024. HHSC must issue a decision within 45 calendar days.

If you're applying on behalf of a parent, you'll need to file Form H1003 (Appointment of an Authorized Representative to Allow Another Person to Act for You) or hold a legal power of attorney.

The Complete Texas Guide

Our Texas Medicare Savings Programs & Extra Help Guide walks through each tier's eligibility rules in detail, with the exact documents you need, a section-by-section Form H1200-EZ walkthrough, the COLA disregard that protects your parent in January through March, and what to do if a provider illegally bills your parent after QMB approval. It includes fillable worksheets for tracking your application and managing provider disputes.

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