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Pinterest Medicare Savings Programs pay for your Part B premium.
$174.70/month
You may get additional benefits based on your income.
Medicare is not free. There are out-of-pocket costs people with Medicare have to pay, including premiums, deductibles, and co-payments. If you have a chronic condition, these costs can add up quickly. Managing them can be difficult if you have low income.
In Texas, there are Medicare Savings Programs (MSPs) that help some Medicare enrollees pay their out-of-pocket costs. You may qualify for an MSP if you are enrolled in Medicare–or are about to enroll–and you have limited income.
What are Medicare Savings Programs?
Medicare Savings Programs (MSPs) are state programs that help people with low income pay for their Medicare costs. There are four MSPs, each with different income and resource eligibility limits. Older adults and younger adults with disabilities who may not qualify for full Medicaid may still be able to enroll in one of the MSPs.
MSPs are available in every state, but not every type of MSP is offered in every state. Most MSPs are administered by a state’s Medicaid office. In Texas, MSPs are administered by Texas Health and Human Services (HHS), the department that runs the Medicaid program.
What are the types of Medicare Savings Programs offered in Texas?
All four MSPs are available in Texas:
- Qualified Medicare Beneficiary (QMB): This program has the lowest income limit and covers Medicare Part A and Part B premiums, deductibles, and copayments for those eligible.
- Specified Low-Income Medicare Beneficiary (SLMB): For those eligible, SLMB covers the Medicare Part B premium.
- Qualifying Individual (QI): QI is a limited program and available on a first-come, first-served basis. For those eligible, QI covers the Medicare Part B premium.
- Qualified Disabled Working Individual (QDWI): This program is less common than the other three MSPs. It helps pay for the Medicare Part A (Hospital Insurance) premium. Most people do not pay a premium for Part A. However, if you’re younger than 65 with a disability, and you returned to work (after collecting Social Security Disability benefits while out of work), you no longer qualify for premium-free Part A. QDWI does not cover the Part B premium.
Special Needs Plan (SNP)
You may also want to find out if you qualify for a Special Needs Plan (SNP). SNPs are a special type of Medicare Advantage plan offering benefits tailored to a specific Medicare population. You may qualify for an SNP if you meet one of the following conditions:
- You have both Medicare and Medicaid (including QMB).
- You have a serious and disabling chronic medical condition.
- You live in a nursing home, or you live at home but have high care needs and could qualify for a nursing home.
Different SNPs are available in different areas of the country. Learn more by contacting the Texas Medicare Help Line at 1-800-252-9240.
Can I get help paying for my prescription drugs in Texas?
Once you're enrolled in a Medicare Savings Program, you will be signed up for the Medicare Part D Extra Help program. If you meet the guidelines for Extra Help, you will have a low (or no) deductible, a low (or no) premium, and no coverage gap. In general, you will pay much less for your prescriptions. You can learn more about Extra Help and even apply on our website.
How do I know if I'm eligible for an MSP in Texas?
In general, you must either be enrolled in Medicare or expect to enroll soon. Each program has its own income limit (the maximum amount of income you can earn in a month or year to qualify) The monthly income limits for MSPs in Texas are listed below and are effective as of March 1, 2024:
Qualified Medicare Beneficiary Program (QMB):
| Family size | Maximum monthly income (100% FPL) |
|---|---|
| Individual | $ 1,255 |
| Couple | $ 1,704 |
Specified Low-Income Medicare Beneficiary (SLMB):
| Family size | Maximum monthly income (100% FPL) |
|---|---|
| Individual | $ 1,526 |
| Couple | $ 2,044 |
Qualifying Individual (QI):
| Family size | Maximum monthly income (100% FPL) |
|---|---|
| Individual | $ 1,695 |
| Couple | $ 2,300 |
Qualifying Disabled Working Individual (QDWI):
| Family size | Maximum monthly income (100% FPL) |
|---|---|
| Individual | $ 2,510 |
| Couple | $ 3,407 |
If you need help with your Medicare costs, you should apply for the MSPs—even if you think your income might be too high. Certain types of income are not counted, and the only way to know for certain if you qualify is to apply.
How do I prepare to apply for the Medicare Savings Programs?
Before you apply, it may be helpful to gather the following information to make your application process easier:
- The amount of income you get from jobs and other sources
- Asset information, such as bank and investment account balances
- Medicare numbers, Social Security numbers, and birth dates of everyone applying or in your household
How do I apply for the Medicare Savings Programs in Texas?
There are a few different ways you can apply for Medicaid in Georgia. Read below to
learn more about which option might be right for you.
The quickest and easiest way to apply for the Medicare Savings Programs and other public assistance benefits is online through your Texas Benefits portal.
All your personal information is kept 100% confidential and protected by special security technology.
Apply From Texas Benefits Portal
To apply by mail, you must first download, print, and complete an application. The applications for MSPs are available in both English and Spanish.
- Download the English application
- Download the Spanish application
Once you have printed and completed the application, mail it to:
Texas Health and Human Services Commission
P.O. Box 149024
Austin, TX 78714-9024
Or mail it to your local HHS service office.
How can I get help with my application?
- Contact your local HHS service office.
- Call the Texas Medicare Help Line at 800-252-9240.
- Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.
NCOA also has a HelpLine you can call to get free support. To get started today, call 1-800-794-6559.
Not sure if you should apply?BenefitsCheckUp helps assess whether you can get help from programs before you apply. Answer questions anonymously to find out if you may be eligible for key benefits assistance, including the Supplemental Nutrition Assistance Program (SNAP), Medicare Savings Programs, Medicaid, Medicare Part D Low Income Subsidy (LIS) - Extra Help, among others.
