Texas SLMB and QI Program — Eligibility, Income Limits, and How They Differ

What SLMB and QI Cover

Both SLMB (Specified Low-Income Medicare Beneficiary) and QI (Qualifying Individual) cover one thing: the monthly Medicare Part B premium. In 2026, that premium is $202.90. Getting it covered puts $2,434 a year back into your parent's Social Security check.

Neither program covers Part A premiums, deductibles, or coinsurance — that's QMB territory. But the Part B premium is the single largest recurring deduction most low-income seniors see from their Social Security payment, and eliminating it can make a real difference in a tight monthly budget.

Both programs also trigger automatic enrollment in Extra Help (the Part D Low-Income Subsidy), which eliminates or dramatically reduces prescription drug costs.

2026 Income Limits

Both tiers share the same asset limit: $9,950 for an individual, $14,910 for a couple. Income limits for 2026:

SLMB (above 100% through 120% FPL):

• Individual: $1,350.01 to less than $1,616/month
• Couple: $1,824.01 to less than $2,184/month

QI (above 120% through 135% FPL):

• Individual: $1,616 to less than $1,816/month
• Couple: $2,184 to less than $2,455/month

All limits include the standard $20 monthly income disregard that Texas applies.

The Critical Difference: Entitlement vs. Block Grant

SLMB is an entitlement. If your parent meets the eligibility criteria, HHSC must approve them. There is no enrollment cap.

QI is different. It runs on a fixed federal block grant allocation, which means enrollment is first-come, first-served. Texas hasn't run out of QI funding in recent memory, but the structural risk exists — and there's a second catch: QI enrollment does not automatically renew. Your parent must complete an annual redetermination packet every year. Miss it, and the benefit stops until they reapply.

One more constraint: QI is exclusive. Your parent can't hold QI and full Medicaid or another MSP tier simultaneously.

HHSC Screens for All Tiers Automatically

When your parent applies for any Medicare Savings Program through Form H1200-EZ or YourTexasBenefits.com, HHSC evaluates eligibility for all four tiers — QMB, SLMB, QI, and QDWI. If income exceeds the QMB ceiling, the caseworker checks SLMB. If it exceeds SLMB, they check QI. Your parent doesn't need to file separate applications.

This is why it's worth applying even if you think your parent earns too much for QMB. A senior with $1,500/month in Social Security wouldn't qualify for QMB ($1,350 limit) but would qualify for SLMB — and get the Part B premium covered.

Retroactive Coverage

Both SLMB and QI provide retroactive coverage: eligibility is effective the first day of the application month, and can extend up to three months before the application date if your parent met the criteria during those months. For QI, retroactive coverage cannot cross a calendar year boundary.

QMB, by contrast, starts only on the first of the month after approval — no retroactive coverage at all. This makes the SLMB/QI retroactive benefit particularly valuable if your parent has been paying the Part B premium for months before applying.

Our Texas Medicare Savings Programs & Extra Help Guide covers the complete SLMB and QI enrollment process, the annual QI renewal timeline, and how to ensure automatic Extra Help activation after approval.

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