Medicare does not have a single income cutoff that determines whether you can enroll. Instead, Texas has several income-based programs layered on top of standard Medicare that can dramatically reduce what you pay each month. Understanding which thresholds apply to your situation is the fastest way to figure out whether you are leaving money on the table.
This guide covers every income limit relevant to Texas Medicare in 2026: the Medicare Savings Programs (QMB, SLMB, QI, and QDWI), Extra Help for prescription drug costs, and the IRMAA surcharges that affect higher earners. Dollar figures below reflect the limits effective March 1, 2026.
Basic Medicare Eligibility Requirements in Texas
Income does not determine whether you qualify for Medicare itself. The basic eligibility rules are:
- You are 65 or older, OR
- You have received Social Security Disability Insurance (SSDI) for at least 24 months, OR
- You have End-Stage Renal Disease (ESRD) requiring dialysis or a kidney transplant, OR
- You have ALS (Lou Gehrig's disease)
You also need to be a U.S. citizen or a lawful permanent resident who has lived in the United States for at least five consecutive years.
Premium-free Part A goes to anyone who (or whose spouse) worked and paid Medicare taxes for at least 40 quarters, roughly 10 years. If you do not meet that threshold, you can still buy Part A coverage, but you will pay a monthly premium.
The standard Part B premium in 2026 is $202.90 per month for most enrollees. This is where income begins to matter, because higher earners pay more through IRMAA surcharges (covered below), and lower-income enrollees can get the premium covered entirely through the Medicare Savings Programs.
Texas Medicare Savings Programs (MSPs): 2026 Income Limits
Texas participates in four federally funded Medicare Savings Programs that help low- and moderate-income beneficiaries pay for Medicare costs. All four programs require Texas residency and enrollment in Medicare Part A.
QMB, SLMB, and QI Income Limits
| Program | Individual Monthly Income | Couple Monthly Income | Benefits Covered |
|---|
| QMB (Qualified Medicare Beneficiary) | Up to $1,350 | Up to $1,824 | Part A and B premiums, deductibles, copays, coinsurance |
| SLMB (Specified Low-Income Medicare Beneficiary) | $1,350 to $1,616 | $1,824 to $2,184 | Part B premium only |
| QI (Qualifying Individual) | $1,616 to $1,816 | $2,184 to $2,455 | Part B premium only |
| QDWI (Qualified Disabled Working Individual) | Up to $1,997 | Up to $2,694 | Part A premium only |
QDWI applies only to disabled individuals under age 65 who have returned to work and lost their premium-free Part A coverage as a result.
Asset Limits for Texas MSPs in 2026
Income alone does not determine eligibility. Texas also applies resource (asset) limits, which exclude your home, one vehicle, and certain personal property.
| Program | Individual Asset Limit | Couple Asset Limit |
|---|
| QMB | $9,660 | $14,470 |
| SLMB | $9,660 | $14,470 |
| QI | $9,950 | $14,910 |
| QDWI | $4,000 | $6,000 |
What QMB Actually Covers
QMB is the most comprehensive program. If you qualify, providers are prohibited by federal law from billing you for Medicare cost-sharing, meaning no copays, no deductibles, and no coinsurance for Medicare-covered services. You also owe nothing on your Part B premium. This can save a QMB enrollee well over $3,000 per year depending on healthcare usage.
SLMB and QI cover only the Part B premium ($202.90/month in 2026), but that still saves eligible enrollees around $2,435 annually.
Extra Help: Medicare Part D Income Limits for 2026
Extra Help (also called the Low Income Subsidy or LIS) is a federal program that reduces what you pay for prescription drugs under Medicare Part D. Unlike the MSPs, Extra Help is administered by the Social Security Administration, not Texas HHSC.
| Household Size | Annual Income Limit | Monthly Equivalent |
|---|
| Individual | $23,475 | approximately $1,956 |
| Married couple | $31,725 | approximately $2,644 |
Resource limits for Extra Help in 2026 are $18,090 for individuals and $36,100 for couples.
If you qualify, Extra Help can:
- Drop your Part D plan premium to zero (or near zero)
- Cap generic drug copays at $5.10 per prescription
- Cap brand-name drug copays at $12.65 per prescription
- Eliminate the coverage gap (donut hole)
Anyone already enrolled in a full MSP (QMB, SLMB, or QI) automatically qualifies for Extra Help, so you do not need to apply separately.
IRMAA: Higher Income Medicare Surcharges for 2026
If your income exceeds a certain threshold, Medicare adds an Income-Related Monthly Adjustment Amount (IRMAA) on top of your standard Part B and Part D premiums. IRMAA is calculated using your Modified Adjusted Gross Income (MAGI) from two years prior, so your 2026 surcharge is based on your 2024 tax return.
2026 Part B IRMAA Brackets
| 2024 MAGI (Individual) | 2024 MAGI (Joint) | Total Monthly Part B Premium |
|---|
| Up to $109,000 | Up to $218,000 | $202.90 (standard) |
| $109,001 to $136,000 | $218,001 to $272,000 | $284.10 |
| $136,001 to $163,000 | $272,001 to $326,000 | $365.30 |
| $163,001 to $192,000 | $326,001 to $384,000 | $446.50 |
| $192,001 to $500,000 | $384,001 to $750,000 | $527.70 |
| Above $500,000 | Above $750,000 | $608.90 |
2026 Part D IRMAA Surcharges
| 2024 MAGI (Individual) | 2024 MAGI (Joint) | Monthly Part D Surcharge |
|---|
| Up to $109,000 | Up to $218,000 | $0 |
| $109,001 to $136,000 | $218,001 to $272,000 | $14.50 |
| $136,001 to $163,000 | $272,001 to $326,000 | $37.90 |
| $163,001 to $192,000 | $326,001 to $272,000 | $61.30 |
| $192,001 to $500,000 | $384,001 to $750,000 | $84.60 |
| Above $500,000 | Above $750,000 | $91.00 |
IRMAA surcharges apply in addition to your plan's regular Part D premium. The surcharge goes to Medicare, not to your plan.
If your income dropped significantly due to a life event (retirement, death of a spouse, loss of income), you can appeal your IRMAA determination by filing Form SSA-44 with the Social Security Administration.
How to Apply for Medicare Savings Programs in Texas
Applications for QMB, SLMB, QI, and QDWI go through Texas Health and Human Services (HHSC). Extra Help applications go through the Social Security Administration.
Step 1: Check Your Income and Assets
Use the income and resource limits above to estimate whether you likely qualify. Remember that certain income types are excluded, including a portion of earned income and some Social Security income, so the calculation is not always straightforward.
Step 2: Gather Required Documents
You will typically need:
- Proof of identity (driver's license, state ID, or passport)
- Proof of Medicare enrollment (Medicare card or award letter)
- Proof of Texas residency (utility bill, lease agreement, or mail)
- Proof of income (Social Security award letter, pay stubs, or pension statements)
- Bank statements and asset documentation for the prior three months
Step 3: Submit Your Application
For QMB, SLMB, QI, and QDWI:
- Apply online at YourTexasBenefits.com
- Call Texas HHSC at 2-1-1 (Texas Information and Referral Network)
- Visit your local HHSC benefits office in person
For Extra Help (Part D):
- Apply online at ssa.gov/extrahelp
- Call Social Security at 1-800-772-1213
- Visit your local Social Security office
Step 4: Get Free Help from Texas SHIP
Texas has a free State Health Insurance Assistance Program (SHIP) that provides one-on-one counseling at no cost. SHIP counselors can help you understand your options, compare plans, and complete applications.
Call Texas SHIP: 1-800-252-9240
Step 5: Use the Benefits Screener
Not sure which programs you qualify for? Run a free eligibility check through our benefits screener to see Medicare Savings Programs, Extra Help, and other assistance you may qualify for in Texas.
For a full overview of Texas assistance programs, visit our Texas benefits guide.
Dual Eligibility: When You Qualify for Both Medicare and Medicaid
Some Texas residents qualify for both Medicare and full Medicaid coverage. This is called dual eligibility or being a "dual-eligible" beneficiary. If you qualify for full Medicaid through Texas HHSC (not just an MSP), Medicaid generally picks up most or all of the costs that Medicare does not cover, including copays, deductibles, and some services Medicare excludes entirely.
Texas has not expanded Medicaid under the Affordable Care Act, so the standard adult Medicaid income limit for aged, blind, or disabled individuals through MEPD (Medicaid for the Elderly and People with Disabilities) is approximately $994 per month for an individual. If you are over 65 or disabled and your income falls near or below that level, you may qualify for both programs simultaneously.
Frequently Asked Questions
What are the Texas Medicare Savings Program income limits for 2026?
The limits effective March 2026 are: QMB covers individuals with monthly income up to $1,350 and couples up to $1,824. SLMB covers individuals from $1,350 to $1,616 and couples from $1,824 to $2,184. QI covers individuals from $1,616 to $1,816 and couples from $2,184 to $2,455.
Does Medicare have an income limit in Texas?
Standard Medicare (Parts A and B) does not have an income limit for enrollment. However, your income affects how much you pay. Lower-income enrollees can qualify for Medicare Savings Programs that cover premiums and cost-sharing. Higher-income enrollees pay IRMAA surcharges on top of the standard Part B premium.
What does QMB cover in Texas?
QMB (Qualified Medicare Beneficiary) covers your Part A and Part B premiums, deductibles, and cost-sharing. Providers cannot legally bill you for Medicare copays or coinsurance if you are enrolled in QMB. This is the most comprehensive of the four Medicare Savings Programs.
How do I apply for Extra Help with Medicare in Texas?
Apply directly through the Social Security Administration at ssa.gov/extrahelp or by calling 1-800-772-1213. Texas residents can also get help from SHIP counselors by calling 1-800-252-9240. If you already receive a full MSP (QMB, SLMB, or QI), you are automatically enrolled in Extra Help.
What is the asset limit for Medicare Savings Programs in Texas in 2026?
For QMB and SLMB, the asset limit is $9,660 for an individual and $14,470 for a couple. For QI, it is $9,950 for an individual and $14,910 for a couple. Your home, one vehicle, and most personal belongings are not counted toward these limits.
Can I get Medicare if I am under 65 in Texas?
Yes. You can qualify for Medicare under 65 if you have received SSDI benefits for 24 consecutive months, have End-Stage Renal Disease, or have ALS. All Medicare Savings Programs and Extra Help are available to under-65 enrollees who meet the income and asset limits.
What is IRMAA and does it apply to Texas Medicare beneficiaries?
IRMAA is an income-related surcharge added to Part B and Part D premiums for higher earners. It applies to all Medicare beneficiaries nationwide, including those in Texas. The surcharge kicks in for individuals with 2024 MAGI above $109,000 (or $218,000 for joint filers). Your 2026 IRMAA is based on income reported on your 2024 federal tax return.
Where can I get free Medicare help in Texas?
Texas SHIP provides free, unbiased Medicare counseling statewide. Call 1-800-252-9240 to reach a local counselor who can review your options at no cost. You can also use our free benefits screener to check eligibility across multiple programs at once.
