What is the income limit for the Medicare savings program in Texas?

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Texas Medicare Savings Program monthly income and resource limits for 2026 depend on the specific program you apply for through Texas Health and Human Services.

2026 Monthly Income and Resource Limits

  • QMB (Qualified Medicare Beneficiary)
    • Individual: $1,350 or less per month
    • Couple: $1,824 or less per month
    • Resources: $9,950 (individual) / $14,910 (couple)
    • What it covers: Part A and Part B premiums, plus deductibles, coinsurance, and copays.
  • SLMB (Specified Low-Income Medicare Beneficiary)
    • Individual: $1,616 or less per month
    • Couple: $2,184 or less per month
    • Resources: $9,950 (individual) / $14,910 (couple)
    • What it covers: Part B premiums only.
  • QI (Qualifying Individual)
    • Individual: $1,816 or less per month
    • Couple: $2,455 or less per month
    • Resources: $9,950 (individual) / $14,910 (couple)
    • What it covers: Part B premiums only (first-come, first-served with limited funding).
  • QDWI (Qualified Disabled and Working Individuals)
    • Individual: $5,405 or less per month
    • Couple: $7,299 or less per month
    • Resources: $4,000 (individual) / $6,000 (couple)
    • What it covers: Part A premiums.

(Note: Income limits often exclude a standard $20 unearned income disregard).

What are the income limits for the Medicare Savings Program in Texas in 2026?

In Texas for 2026, the monthly income limits for the Medicare Savings Programs depend on the specific program and your household size (individual vs. couple).

Monthly Income Limits (2026)

  • Qualified Medicare Beneficiary (QMB) (100% of the Federal Poverty Level)
    • Individual: Up to $1,330 per month
    • Couple: Up to $1,804 per month
  • Specified Low-Income Medicare Beneficiary (SLMB) (100% to less than 120% of FPL)
    • Individual: $1,330.01 to less than $1,596 per month
    • Couple: $1,804.01 to less than $2,164 per month
  • Qualifying Individual (QI-1) (120% to less than 135% of FPL)
    • Individual: $1,596 to $1,796 per month
    • Couple: $2,164 to $2,435 per month
  • Qualified Disabled Working Individual (QDWI)
    • Individual: Up to $2,660 per month

(Note: Most program calculations exclude a standard $20 general income disregard from your gross monthly income.)

Asset and Resource Limits

For QMB, SLMB, and QI-1, Texas enforces a resource/asset limit:

  • Individual: $9,950
  • Couple: $14,910
    (Primary homes, one vehicle, and personal/household goods are typically excluded from this asset test.)

What is the income limit to qualify for the Medicare savings program?

The monthly income limits for the Medicare Savings Programs depend on the specific program and whether you are applying as an individual or a married couple.

For the 48 contiguous states and the District of Columbia in 2026, the baseline monthly income limits (including a $20 general income disregard) are:

1. Qualified Medicare Beneficiary (QMB) Program

Covers Part A and Part B premiums, plus deductibles, copays, and coinsurance.

  • Individual: $1,350 per month
  • Married Couple: $1,824 per month

2. Specified Low-Income Medicare Beneficiary (SLMB) Program

Covers the Part B premium.

  • Individual: $1,616 per month
  • Married Couple: $2,184 per month

3. Qualifying Individual (QI) Program

Covers the Part B premium (first-come, first-served basis).

  • Individual: $1,816 per month
  • Married Couple: $2,455 per month

4. Qualified Disabled Working Individual (QDWI) Program

Covers the Part A premium for working people with disabilities under age 65.

  • Individual: $5,405 per month
  • Married Couple: $7,299 per month

Note: Income limits are higher in Alaska and Hawaii. Furthermore, many states set higher income limits or have eliminated resource/asset tests completely. You can check the details for your area through the Medicare Savings Programs Guidelines.

What are the income limits for QMB in 2026 for people over 65?

In 2026, the baseline monthly income limits for the Qualified Medicare Beneficiary (QMB) program in the lower 48 states are $1,350 for an individual and $1,824 for a married couple.

QMB Limits and Asset Guidelines

  • Individual monthly income limit: $1,350 (includes a standard $20 income disregard from gross income).
  • Married couple monthly income limit: $1,824.
  • Individual resource/asset limit: $9,950.
  • Married couple resource/asset limit: $14,910.

Important Details to Keep in Mind

  • Exceptions by State: Alaska and Hawaii have higher income guidelines due to different federal poverty levels. Certain states (like Connecticut or the District of Columbia) also use higher limits or have eliminated asset tests entirely.
  • What QMB Covers: It helps pay for Medicare Part A and Part B premiums, as well as Medicare deductibles, coinsurance, and copayments.

How much money can I make and still be eligible for Medicare?

There is no maximum income limit to be eligible for Medicare. If you are 65 or older, or if you qualify due to a specific disability, you are eligible to enroll in Medicare regardless of how much money you earn.

However, your income does dictate how much you pay for your monthly premiums. If your Modified Adjusted Gross Income (MAGI) exceeds certain thresholds, you will trigger a surcharge called the Income-Related Monthly Adjustment Amount (IRMAA).

Medicare Income Brackets & Premiums

Medicare premium surcharges are based on the tax return you filed two years prior. For example, your costs are determined by your 2024 tax return.

If your income falls below or within the base bracket, you pay the standard premiums:

  • Single Filers: $109,000 or less
  • Joint Filers: $218,000 or less
  • Standard Part B Premium: $202.90 per month

If you earn more than these amounts, your monthly Part B premium scales up on a sliding bracket system from $284.10 up to $689.90, and an extra surcharge between $14.50 and $91.00 is added to your Part D prescription plan premium.

Financial Assistance for Lower Incomes

While high incomes increase your costs, having a limited income can qualify you for programs that pay for your premiums and out-of-pocket medical costs. You can check guidelines through the Medicare Savings Programs (MSPs) or the Social Security Administration Extra Help Program to see if you qualify for premium subsidies.

Medicare Savings Program Explained (Who Qualifies in Texas?)

9 related questions found

What is the maximum income for Medicare in 2026?

There is no maximum income limit that disqualifies you from receiving Medicare, but earning above $109,000 as a single filer or $218,000 as a married couple filing jointly in 2026 will trigger higher monthly premiums.

Medicare Income Thresholds (IRMAA)

Medicare does not have an upper income cutoff, but higher-income beneficiaries pay an extra charge called the Income-Related Monthly Adjustment Amount (IRMAA) for Part B and Part D. These 2026 fees use your modified adjusted gross income (MAGI) from your 2024 tax return.

  • No Surcharge (Standard Premium): $109,000 or less for single filers; $218,000 or less for joint filers.
  • Highest Surcharge Tier: $500,000 or more for single filers; $750,000 or more for joint filers. At this top level, the Part B total monthly cost reaches $689.90, plus an additional $91.00 for Part D.

Medicare Tax on Earnings

If you are asking about paying taxes to fund Medicare while working:

  • There is no maximum earnings limit for the Medicare tax.
  • You must pay Medicare tax on all of your covered wages or self-employment income, unlike Social Security which stops taxing earnings above $184,500 in 2026.

Is the Medicare savings program worth it?

Enrolling in a Medicare Savings Program is financially worth it if you meet the income and resource limits, as it can save you thousands of dollars each year on premiums and out-of-pocket costs.

Key Benefits

  • Premium Savings: Programs like SLMB and QI cover your monthly Medicare Part B premium, which is $202.90 in 2026, putting over $2,400 back in your pocket annually.
  • Comprehensive Cost-Sharing Coverage: The Qualified Medicare Beneficiary (QMB) program goes further by covering Part A and Part B deductibles, coinsurance, and copayments. If you are in QMB, medical providers are strictly prohibited by law from billing you for Medicare cost-sharing.
  • Automatic Extra Help: Qualifying for any Medicare Savings Program automatically enrolls you in the Medicare Part D Low-Income Subsidy (Extra Help), which is valued at thousands more in prescription drug savings.
  • No Gifting Penalties: Unlike traditional full Medicaid, these programs do not have a lookback period or asset-gifting penalties.

Considerations

  • State Variations: Income and asset limits differ by state, and some states have eliminated asset tests entirely, meaning you might qualify even if federal baselines seem too strict.
  • Application Effort: The application requires going through your state's Medicaid office, and renewal can involve annual recertification paperwork.

How long does it take to get approved for the Medicare savings program?

It typically takes 30 to 45 days to get a decision on a Medicare Savings Program (MSP) application.

Approval Timeline

  • Decision Notice: Your local state Medicaid office should send an approval or denial letter within 45 days of receiving your completed application.
  • Benefit Activation: Once approved, it can take an additional 3 to 4 months for your state's system and the Social Security Administration to fully process and stop premium deductions from your checks.
  • Retroactive Pay: Benefits are typically retroactive to your official approval date, meaning you will eventually be reimbursed for any out-of-pocket premiums deducted during the processing delay.

What disqualifies you from Medicare?

You are disqualified from Medicare if you do not meet basic age, citizenship, or residency requirements.

Disqualifying Factors

  • Age under 65: If you are under 65 and do not have a qualifying disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's disease), you cannot get Medicare.
  • Lack of citizenship or legal residency: You are disqualified if you are not a U.S. citizen or a permanent legal resident who has lived in the U.S. continuously for at least five consecutive years. People on temporary visas do not qualify.
  • Incarceration: While prison does not permanently erase base eligibility, active incarceration in a federal, state, or local facility suspends Medicare's payment of medical bills during the sentence.
  • Living abroad: Medicare does not pay for healthcare services delivered outside the United States.

Note: Having a low income or a poor work history does not disqualify you. If you lack the work credits for premium-free Part A, you can simply pay a monthly premium to buy into it.

Why am I paying $700 a month for Medicare?

You are likely paying close to $700 a month because of an income-based surcharge called IRMAA (Income-Related Monthly Adjustment Amount) added to your Social Security Administration Benefits Planner.

Why the Cost is High

  • The IRMAA Surcharge: While the standard Medicare Part B monthly premium is $202.90, higher earners must pay an extra surcharge. If your total monthly cost reaches nearly $700, your past income has pushed you into a higher IRMAA bracket.
  • Look-Back Period: Medicare determines IRMAA using your Modified Adjusted Gross Income (MAGI) from two years prior. A high-income tax return from two years ago dictates your current monthly bill.
  • Combined Parts: This total often includes surcharges for both Part B (outpatient care) and Part D (prescription drug coverage).
  • Automatic Deduction: This amount is typically taken directly out of your monthly Social Security check or billed quarterly if you are not yet collecting benefits.

What You Can Do

  • Check for Life-Changing Events: If you experienced a major income drop due to a life-changing event (such as marriage, divorce, or work reduction), you can appeal to have your surcharge lowered.
  • Review Details: You can check specific rules and thresholds directly through AARP's Medicare Guide or contact Social Security.