Medicare Savings Program tools for counting income eligibility

Medicare Savings Program in Texas

The Medicare Savings Programs in Texas are available to people who qualify for Medicare but have limited income. These programs help beneficiaries with paying the costs of Medicare Part A and Part B. When you enroll in a Medicare Savings Program, you will also automatically get enrolled in Extra Help. Extra Help is another federal program that helps pay most of your Medicare prescription drug (Part D) plan costs.

Medicare Savings Program Texas

If you are living in Texas you have a couple of options for enrolling in the Medicare Savings Program. The state of Texas offers four Medicare Savings programs: Qualified Medicare Beneficiary program (QMB), Specified Low-Income Medicare Beneficiary program (SLMB), Qualified Individual Program (QI), and Qualified Disabled and Working Individual program (QDWI).

Qualified Medicare Beneficiary

Qualified Medicare Beneficiary program pays for Original Medicare – Part A and B if you are enrolled in at least Part A and if you met the income and resources requirements. The maximum monthly income limit for singles is $1153 and $1546 for married couples. Maximum financial resources when added up must not be of value bigger than $8400 for a single individual, or $12600 for couples. However, be aware that with QMB you would not receive standard state Medicaid benefits, instead, you will receive a QMB card, which you need to show to medical providers. Texas Health and Human Services Commission provides QMB cards.

Specified Low-Income Medicare Beneficiary

The Specified Low-Income Medicare Beneficiary program is designed to help you pay your Medicare Part B monthly premium. To be eligible for this program your monthly income should be between $1133 and $1379 for single individuals and between $1526 and $1851 for couples. When added, your resources should not be bigger than $8400 for single individuals, and $12600 for couples.

Qualifying Individual

Qualifying Individual program will help you with paying Medicare Part B monthly premium if you met eligibility requirements. It is important to know that you cannot be eligible for Medicaid and QI simultaneously. If you are eligible for the QI program then you won’t be receiving Medicaid benefits. The monthly income limit for single individuals is from $1379 to $1549, and between $1851 and $2080 for couples. Maximum financial resources when added up must be up to $8400 for a single individual or up to $12600 for couples.

Qualified Disabled and Working Individual

The Qualified Disabled and Working Individual program covers the Medicare Part A premiums for disabled individuals younger than age 65 who lost their premium-free Part A because they returned to work. The monthly income requirement is $4615 for single individuals and $6189 for couples. All resources added up cannot be higher than $4000 for individuals, and $6000 for couples.

Why Apply for Medicare Savings Program?

Individuals with disabilities and the elderly population who are not receiving Medicaid benefits still can enroll in the Texas Medicare Savings Programs. There are two major advantages to consider:

  • You will save money on Medicare costs. Three of the four Savings Programs cover the Medicare Part B premium, which in 2023 is $164.90 a month.
  • You will be automatically enrolled in Extra Help. Enrollment into Medicare Savings Programs automatically “deems” a person eligible to receive the Medicare Part D Low Income Subsidy. This benefit helps pay for prescription drugs. Have in mind that if enrolled automatically in Extra Help, and have not been enrolled in Medicare Part D before, then you will not be exposed to a late enrollment penalty.

Texas Medicare Savings Program Application

Before you start your application, be sure that you are enrolled in Medicare Part A. If you are not a Medicare beneficiary, then you first need to enroll in Original Medicare, or Part A at least to be able to get Medicare Savings benefits.

If you are already a Medicare beneficiary, and you met the requirements needed for the program you want to enroll in, then you need to complete “Application for Benefits: Texas Health and Human Services Commission”. You can download its PDF version from Texas Health and Human Services Commission website, print it, fill it out and then physically send it via mail or fax. You can also do an online application through the website “Your Texas Benefits”.

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