The Medicare Savings Program (MSP) in Texas is a state-run benefit that helps pay some or all of your Medicare costs, including premiums, deductibles, and copayments. Texas offers four levels of the program, each covering different expenses depending on your income. The programs are administered by Texas Health and Human Services, and qualifying for any of them also gets you automatic enrollment in Extra Help, which lowers your prescription drug costs under Medicare Part D.
The Four Program Levels
Each MSP level covers a different slice of your Medicare costs. The more financial need you demonstrate, the more costs the program picks up.
Qualified Medicare Beneficiary (QMB) is the most comprehensive. It covers your Part A premiums (if you pay them), Part B premiums, and all Medicare deductibles, coinsurance, and copayments. Doctors and hospitals that accept Medicare cannot bill you for these cost-sharing amounts if you have QMB. Texas sends you a special identification card to show your providers.
Specified Low-Income Medicare Beneficiary (SLMB) covers only your Part B premium. You need to already have both Part A and Part B to qualify. You won’t receive a monthly Medicaid identification card or any regular Medicaid benefits.
Qualifying Individual (QI) also covers only your Part B premium and requires you to have both Part A and Part B. The key difference from SLMB is the income threshold is slightly higher. However, you cannot receive QI benefits if you’re already enrolled in any other Medicaid-funded program.
Qualified Disabled and Working Individual (QDWI) is the narrowest program. It covers only your Part A premium. This is designed for people under 65 who lost their premium-free Part A coverage because they returned to work.
None of these programs give you full Medicaid benefits. They exist solely to reduce your Medicare costs.
Income and Resource Limits
Eligibility is based on your monthly income and countable resources. Income limits for QMB, SLMB, and QI are tied to the federal poverty level and updated annually, typically in early spring when new FPL figures are published. For QDWI, the income limit is 200% of the federal poverty level. As of March 2025, that means $2,609 per month for an individual or $3,525 for a couple. All programs also apply a $20 monthly income disregard, meaning the first $20 of your income isn’t counted.
Resource limits apply to QMB, SLMB, and QI. Starting January 1, 2026, the limits are $9,950 for an individual and $14,910 for a couple. Resources include bank accounts, stocks, bonds, and similar assets.
What Doesn’t Count as a Resource
Your primary home is excluded from the resource calculation as long as you, your spouse, or a dependent relative lives there. This applies whether the home is a house, a mobile home, or even a houseboat. If you’ve temporarily left your home but intend to return, it’s still excluded. If you’re in a long-term care facility and your spouse still lives in the home, it remains excluded. Real property you’ve put up for sale is also exempt.
These exclusions mean that owning a home does not disqualify you, which is a common concern for people considering the program.
Automatic Extra Help for Prescriptions
One of the biggest perks of qualifying for any MSP level is that your information is automatically sent to the Centers for Medicare and Medicaid Services, enrolling you in Extra Help (also called the Low-Income Subsidy). Extra Help significantly reduces what you pay for prescription drugs under a Medicare Part D plan. You don’t need to file a separate application with Social Security. The enrollment happens behind the scenes once your MSP eligibility is confirmed.
How to Apply in Texas
You apply through Texas Health and Human Services using Form H1200, which is the general application for Medicaid for the Elderly and People with Disabilities as well as the Medicare Savings Program. The form is available in both English and Spanish. You can submit it online through the YourTexasBenefits.com portal, by mail, or in person at a local HHS office.
Processing times depend on your situation. If you’re 65 or older, or if your disability has already been established through Social Security (either SSDI or SSI), Texas HHS must make an eligibility decision within 45 days. If your disability still needs to be evaluated by the state’s Disability Determination Unit, the timeline extends to 90 days.
For help with the application or questions about your eligibility, you can call 2-1-1 from any Texas phone, or reach the toll-free line at 877-541-7905. For Medicare-specific services, the number is 800-252-9240.
Which Program Level Fits Your Situation
If your income is low enough to qualify for QMB, that’s the clear winner. It eliminates virtually all out-of-pocket Medicare costs, saving you hundreds of dollars a month between premiums, deductibles, and copayments. If your income is slightly too high for QMB but you’re struggling with the Part B premium (which runs $185 or more per month for most people in 2025), SLMB or QI can take that cost off your plate entirely.
QDWI serves a narrow but important purpose: if you’re a working person with a disability who lost premium-free Part A, this program prevents you from having to pay that premium yourself, which can exceed $500 per month.
Because the income thresholds differ across the four programs, it’s worth applying even if you’re unsure which one you qualify for. Texas HHS will evaluate your eligibility for each level during the application process and place you in the highest-benefit program your income supports.