How to apply for Medicare Savings Programs in Texas (QMB, SLMB, QI-1)

Who it's for

Texas's Medicare Savings Programs use Medicaid funds to pay all or some of your Medicare costs. Qualified Medicare Beneficiary (QMB) pays Medicare premiums, deductibles, and co-insurance. Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI-1) pay the Medicare Part B premium. You must be entitled to Medicare Part A. The monthly income limits are QMB up to $1,330 for one person or $1,804 for a couple, SLMB up to $1,596 or $2,164, and QI-1 under $1,796 or $2,435. Countable resources must be $9,660 or less for one person or $14,470 for a couple. People who get other Medicaid cannot get QI-1. Apply online at YourTexasBenefits.com, call 2-1-1 for help, or call the free Texas Medicare helpline at 1-800-252-9240 to reach a benefits counselor who can help you apply.

What you'll need

• Medicare card (showing Part A)
• Proof of income
• Proof of savings and other resources

Where to apply

What to say when you call

"Hello, I'm calling to ask about Medicare Savings Programs in Texas (QMB, SLMB, QI-1). I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need medicare card (showing Part A), proof of income, proof of savings and other resources — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Check that you have or can get Medicare Part A. These programs are for people with Medicare Part A and have income and savings limits.
2. Compare your income to the program limits. QMB has the lowest income limit and the most help. SLMB and QI-1 have higher income limits, but QI-1 can close if the state's yearly funding runs out and you cannot get QI-1 if you get other Medicaid.
3. Gather your documents. Have your Medicare card showing Part A, proof of income, and proof of savings and other resources ready.
4. Apply online through the Texas benefits application system, or apply by phone at 1-800-252-9240.
5. Call 2-1-1 or the free Texas Medicare helpline at 1-800-252-9240 if you need help with the application.
6. Complete any follow-up requests from Texas Health and Human Services Commission. The state Medicaid agency makes the final decision.

What to expect: After you apply, Texas Health and Human Services Commission reviews your information and decides whether you qualify for QMB, SLMB, or QI-1. If your income is lower, you may qualify for more help, including QMB, which also pays Medicare deductibles and co-insurance. Processing times vary, so ask the agency for an estimate if needed. If approved, you will need to renew every year.

Renewals

annual