Texas QMB Income Limits 2026 — Eligibility Rules and How to Qualify

2026 QMB Income Thresholds in Texas

To qualify for QMB in Texas, your parent's countable monthly income must fall at or below 100% of the Federal Poverty Level. For 2026, that means:

• Individual: $1,350/month gross (after the $20 disregard, the countable limit is $1,330)
• Couple: $1,824/month gross (countable limit: $1,804)

HHSC applies a mandatory $20 monthly general income disregard to all MSP applicants. If your parent's Social Security check is $1,345, their countable income is $1,325 — safely under the QMB individual limit.

Asset Limits

QMB uses the same resource limits as SLMB and QI:

• Individual: $9,950 in countable assets
• Couple: $14,910 in countable assets

Countable assets include bank accounts, CDs, stocks, accessible retirement accounts (IRAs and 401(k)s where the owner can withdraw), and life insurance cash surrender value if total face value exceeds $1,500. Texas excludes the primary home regardless of value, one vehicle, personal belongings, and up to $1,500 in burial funds per person.

Joint bank accounts create a wrinkle: HHSC presumes all funds belong to the applicant unless the co-holder provides deposit records and written statements proving their ownership.

What Doesn't Count as Income

Not everything hitting your parent's bank account counts toward the limit. HHSC applies the $20 disregard and excludes qualifying Social Security lump sums temporarily, but it counts gifts or contributions and the value of shelter paid by someone else.

• The first $20 of unearned income per month (the general disregard) Lump-sum Social Security back payments — including retroactive adjustments from the Social Security Fairness Act — are excluded from resources for nine months after receipt. After nine months, any unspent balance becomes countable.

The COLA Disregard Protects Your Parent in January

Social Security checks increase every January with the Cost-of-Living Adjustment, but the Federal Poverty Level doesn't update until April 1. Without a fix, that three-month gap would push some QMB recipients over the income limit. Texas solves this with a COLA disregard: HHSC caseworkers ignore the January COLA increase from January through March, so your parent's eligibility isn't disrupted by a few extra dollars. If they get a denial letter in that window citing the COLA increase, that's a processing error worth appealing.

What QMB Covers

QMB is the most generous MSP tier. Once approved, it pays:

• The monthly Part B premium ($202.90 in 2026)
• The Part A hospital deductible ($1,736 per benefit period)
• The Part B annual deductible ($283)
• All coinsurance and copayments for Medicare-covered services

Providers cannot bill QMB recipients for any of these amounts — it's a federal violation under 42 CFR § 447.15.

If Your Parent Is Just Over the Limit

Don't walk away from the application. If income exceeds the QMB limit, HHSC automatically screens for SLMB (below $1,616/month individual) and QI ($1,616 to below $1,816/month individual), both of which cover the Part B premium. That's $202.90/month back in your parent's pocket.

Our Texas Medicare Savings Programs & Extra Help Guide includes the full income-counting rules, worksheets for calculating countable income and assets, and the COLA disregard timeline so you know exactly where your parent stands.

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