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and Applying for:
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âś” Medicaid – for the elderly and people with
disabilities
âś” Medicaid – for low income families
âś” Medicaid – SNAP Food Benefits
âś” Medicaid – Recently Denied Assistance

Medicare Savings Programs

Get help from your state paying your Part A (Hospital Insurance) and Part B (Medical Insurance) premiums through a Medicare Savings Program. If you qualify, Medicare Savings Programs might also pay your Part A and Part B deductibles, coinsurance, and copayments.

You’ll apply for Medicare Savings Programs through your state. When you apply, your state determines which program(s) you qualify for. Even if you don’t think you qualify, you should still apply.

What’s a premium, deductible, coinsurance, or copayment?

How to qualify for the 4 Medicare Savings Programs

In many cases, to qualify for a Medicare Savings Program, you must have income and resources below a certain limit, as described below. These limits go up each year.

You may still qualify for these programs in your state even if your income or resources are higher than the federal limits listed. Some states don’t count certain types or specific amounts of income or resources when deciding who qualifies.

Contact Your State

Qualified Medicare Beneficiary (QMB) Program

Helps pay for: Part A premiums; Part B premiums, deductibles, coinsurance, and copayments (for services and items Medicare covers).

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $1,325 $9,660
Married couple $1,783 $14,470

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

If you qualify for the QMB program:

  • Medicare providers aren’t allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments. What should I do if I get a bill?
  • You may get a bill for a small Medicaid copayment, if one applies.
  • You’ll also get Extra Help paying for your prescription drugs. You’ll pay no more than $12.15 in 2025 for each drug covered by your Medicare drug plan.
Show both your Medicare card and Medicaid card (or QMB card) each time you get care. If you have Original Medicare, you can also show one of your claims statements, called Medicare Summary Notices. These statements show you’re in the QMB program. Get a sample of a Medicare Summary Notice.

Specified Low-Income Medicare Beneficiary (SLMB) Program

Helps pay for: Part B premiums (You must have both Part A and Part B to qualify.)

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $1,585 $9,660
Married couple $2,135 $14,470

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

If you qualify for the SLMB Program: 

  • You’ll also get Extra Help paying for your prescription drugs.
  • You’ll pay no more than $12.15 in 2025 for each drug your Medicare drug plan covers.

Qualifying Individual (QI) Program

Helps pay for: Part B premiums (You must have both Part A and Part B to qualify.)

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $1,781 $9,660
Married couple $2,400 $14,470

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

If you qualify for the QI program:

  • You must apply every year to stay in the QI Program.
  • States approve applications on a first-come, first-served basis – priority is given to people who got QI benefits the previous year.
  • You’ll also get Extra Help paying for your prescription drugs. You’ll pay no more than $12.15 in 2025 for each drug your Medicare drug plan covers

QI is only available for people who don’t qualify for any other Medicaid coverage or benefits, but you may qualify for help from another Medicare Savings Program.

Qualified Disabled & Working Individual (QDWI) Program

You may qualify for the QDWI Program if you:

  • Have a disability
  • Are working
  • Lost Your Social Security disability benefits and Medicare premium-free Part A because you returned to work

Helps pay for: Part A premiums only

Monthly income and resource limits for 2025:

Your situation: Monthly income limit:*

Resource limit:

What counts in resource limits?

Individual $5,302 $4,000
Married couple $7,135 $6,000

* Income limits slightly higher in Alaska and Hawaii. You may qualify in other states for these programs even if your income or resources are higher than the federal limits listed. Contact your state to find out.

How to apply for a Medicare Savings Program

These programs are run by your state. Contact your state to apply.

What do you want to do next?

  • Next Step: Lower your drug costs
  • Take Action: Talk to someone
  • Get details: Learn about Medicaid

 

Children’s Medicaid and CHIP

Children in Texas might be able to get low-cost or free health coverage through Children’s Medicaid or the Children’s Health Insurance Program (CHIP).

Children’s Medicaid is a health care program for children in low-income families. CHIP is a health care program for children without health insurance whose families earn too much to get Medicaid but cannot afford health insurance.

To get Children’s Medicaid or CHIP, a child must be:

  • 18 years old or younger. (In some cases, children with disabilities who are 19 or 20 years old can get Medicaid.)
  • a Texas resident; and
  • a U.S. citizen or qualified non-citizen.

When you apply, we’ll ask about your family’s income to see which programs your child can get. See income guidelines below.

Apply for Medicaid and CHIP.

Services Covered by Children’s Medicaid and CHIP

  • Regular checkups at the doctor and dentist
  • Medicine and vaccines
  • Hospital care and services
  • X-rays and lab tests
  • Vision and hearing care
  • Access to medical specialists and mental health care
  • Treatment of special health needs and pre-existing conditions

These services are provided by health plans. If your child gets Medicaid or CHIP, you will choose a plan from the ones available in your service area.

Children with Disabilities

Children with disabilities can get long-term services and supports through Children’s Medicaid. These services can include:

  • Home care and personal care, like having someone help monitor your child’s health and help them with daily activities.
  • Having someone help take your child to their medical appointments.
  • Nursing home care.
  • A hospital for mental illnesses.
  • A place of care for people with intellectual disabilities.

Learn about Medicaid programs for children and adults with disabilities.

CHIP Does Not Cover Long-Term Services and Supports

If you have a child with a disability and make too much money to get Children’s Medicaid, you might be able to get coverage through the Medicaid Buy-In for Children (MBIC) program. MBIC allows families of children with disabilities to make a monthly payment to get Medicaid coverage.

Learn about other programs and services for people with disabilities.

Income Guidelines for Children’s Medicaid

Your income is the money you get paid before taxes are taken out. Find your family size on the table below. If your monthly income is the same or less, your child might be eligible for Children’s Medicaid.

 
Family Members (Adults plus children) Monthly Family Income

Family Members (Adults plus children)

1*

Monthly Family Income

$1,735

Family Members (Adults plus children)

2

Monthly Family Income

$2,345

Family Members (Adults plus children)

3

Monthly Family Income

$2,954

Family Members (Adults plus children)

4

Monthly Family Income

$3,564

Family Members (Adults plus children)

5

Monthly Family Income

$4,173

Family Members (Adults plus children)

6

Monthly Family Income

$4,783

Family Members (Adults plus children)

7

Monthly Family Income

$5,393

Family Members (Adults plus children)

8

Monthly Family Income

$6,002

Family Members (Adults plus children)

For each additional person, add:

Monthly Family Income

$610

*A family of one might be a child who does not live with a parent or other relative.

If your income is higher than the limits listed above, see the income guidelines for CHIP below.

Income Guidelines for CHIP

Your income is the money you get paid before taxes are taken out. Find your family size on the table below. If your monthly income is the same or less, your child might get CHIP.

 
Family Members (Adults plus children) Monthly Family Income

Family Members (Adults plus children)

1*

Monthly Family Income

$2,622

Family Members (Adults plus children)

2

Monthly Family Income

$3,543

Family Members (Adults plus children)

3

Monthly Family Income

$4,464

Family Members (Adults plus children)

4

Monthly Family Income

$5,386

Family Members (Adults plus children)

5

Monthly Family Income

$6,307

Family Members (Adults plus children)

6

Monthly Family Income

$7,228

Family Members (Adults plus children)

7

Monthly Family Income

$8,149

Family Members (Adults plus children)

For each additional person, add:

Monthly Family Income

$922

*A family of one might be a child who does not live with a parent or other relative.

How Much Does It Cost?

Children’s Medicaid is free.

If we find your child is eligible for Children’s Medicaid, there is no cost to receive services.

CHIP fees vary based on your income.

If we find your child is eligible for CHIP, your enrollment fee and co-pays will be based on your family’s income. Enrollment fees are $50 or less per family, per year.

Co-pays for doctor visits and medicine range from $3 to $5 for lower-income families and $20 to $35 for higher-income families.

Sample Text

 

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SNAP Food Benefits

What it Offers

The Supplemental Nutrition Assistance Program (SNAP) helps people buy the food they need for good health. People also can buy garden seeds with SNAP benefits.

SNAP food benefits are put on a Lone Star Card and can be used just like a credit card at any store that accepts SNAP.

SNAP can’t be used to:

  • Buy tobacco.
  • Buy alcoholic drinks.
  • Buy things you can’t eat or drink.
  • Pay for food bills you owe.

You can also use your SNAP benefits to buy food online. Learn more about buying food online with SNAP.

Who is it for?

  • People in eligible low-income households.
  • Most adults ages 18 to 52 with no children in their home can get SNAP for only three months in a three-year period. The benefit period might be longer if the person works at least 20 hours a week or is in a job or training program. Some adults might not have to work to get benefits, such as those who have a disability or are pregnant.
  • Households in which all members are either older adults (age 60 and older) or people with disabilities are eligible to participate in the Texas Simplified Application Project (TSAP), which makes the SNAP application process easier and provides three years of benefits at a time instead of six months.

Maximum Monthly Income Limits

The following chart gives a general idea of the amount of money (income) that most people or families can earn and still be in this program.
Family size Maximum monthly income
Family size 1 Maximum monthly income $ 2,005
Family size 2 Maximum monthly income $ 2,712
Family size 3 Maximum monthly income $ 3,419
Family size 4 Maximum monthly income $ 4,125
Family size 5 Maximum monthly income $ 4,832
Family size For each additional person, add: Maximum monthly income $ 707

Other Rules

Most people ages 16 to 59 must follow work rules to get SNAP benefits. Work rules mean a person must look for a job or be in an approved work program. If the person has a job, they can’t quit without a good reason.

Maximum Monthly SNAP Amount

Most people ages 16 to 59 must follow work rules to get SNAP benefits. Work rules mean a person must look for a job or be in an approved work program. If the person has a job, they can’t quit without a good reason.
Family size Monthly SNAP amount
Family size 1 Monthly SNAP amount $291
Family size 2 Monthly SNAP amount $535
Family size 3 Monthly SNAP amount $766
Family size 4 Monthly SNAP amount $973
Family size 5 Monthly SNAP amount $1,155
Family size 6 Monthly SNAP amount $1,386
Family size 7 Monthly SNAP amount $1,532
Family size 8 Monthly SNAP amount $1,751
Family size For each additional person, add: Monthly SNAP amount $219

Have you lost or been denied Medicaid

Medicare Coverage

If you recently lost (or will soon lose) Medicaid, you may be able to sign up for Medicare or change your current Medicare coverage. Don’t wait. If you qualify, you’ll have a limited time to sign up or make changes.

If you now qualify for Medicare but didn’t sign up for it when you first became eligible:

  • You can sign up for Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), or both without paying a late enrollment penalty.
  • You have 6 months after your Medicaid coverage ends to sign up.
  • You can sign up by filling out a CMS-10797 form and mailing or faxing it to your local Social Security office. You can also call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

Remember: Your Medicare coverage will start the month after you sign up, or the date your Medicaid coverage ends, whichever you choose.

If you have Medicare and Medicaid, and you lose Medicaid, you can:

  • Join a Medicare Advantage Plan with drug coverage or Medicare drug plan, if you don’t already have one.
  • Change your current Medicare Advantage Plan or Medicare drug plan.
  • Join a plan or make coverage changes for 3 months from the date your state notifies you that your Medicaid coverage is ending, or the date your Medicaid coverage ends, whichever’s later.

Note: If you drop a Medicare Advantage Plan, you have the option to return to Original Medicare.

Want to learn more about Medicare coverage?

Call (972) 223-7979 to get help TODAY!

Marketplace Coverage

Get Marketplace coverage if you lose or are denied Medicaid or CHIP coverage

If your state finds that your household income is too high or other items make you ineligible, you may be denied or lose your Medicaid or Children’s Health Insurance Program (CHIP) coverage.

Notice:

Your state regularly checks if you’re still eligible to keep Medicaid or CHIP—called a renewal process. Your state will reach out to you if they need more information. Complete and submit any forms your state asks for right away.

The Marketplace offers health coverage

You may be able to get Marketplace health coverage with savings if you or others in your household:

  • Had Medicaid or CHIP coverage, but lost it.
  • Currently have Medicaid or CHIP coverage, but will lose it soon.
  • Applied for Medicaid or CHIP coverage through your state agency and the state denied your application.
  • Applied for coverage with the Marketplace and were found potentially eligible for Medicaid or CHIP coverage. Your state checked if you could get Medicaid or CHIP, but said you (or your household member(s)) don’t qualify.
Explore your health care options (PDF, 380 KB).

Local help in your community

Give us a call (972) 223-7979 to enroll in Marketplace coverage. 

Don’t wait when it comes to your families health insurance coverage.

To get help with your coverage options or to apply for Marketplace coverage, find local help near you.

Warning:

Say no to scams
Don’t share your personal information or give money to anyone saying you have to pay them to keep Medicaid or CHIP coverage or apply for Marketplace coverage. Our Local Agents, and your state will never threaten you or anyone in your household or ask for your credit card information or payment to keep or qualify for health coverage.

Notice:

If you’re a member of a Federally-recognized tribe or an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder, you may be able to get additional cost savings when you enroll in a qualified Marketplace health plan. Get more health coverage information for American Indians & Alaska Natives.

Answering application questions

Select your situation to answer questions about Medicaid and CHIP on your Marketplace application:
  • Someone in my household lost (or will soon lose) Medicaid or CHIP.
  • Someone in my household recently applied for Medicaid or CHIP and the state denied their application.
  • Someone in my household applied for state or Marketplace coverage during a certain period of time.
  • Someone in my household has special health care needs (like a disability or a condition that requires help with daily living activities).

Your application results

You’ll get results right away telling you if you or others in your household qualify for health coverage through the Marketplace. Based on how you answer your application questions, we may also check to see if you could still qualify for Medicaid or CHIP coverage. Review your results—they include:
  • Information about savings on your Marketplace plan
  • Other actions you may need to take to confirm your information
  • Enrollment deadlines

Your eligibility results will also tell you if you or anyone in your household qualifies for a Special Enrollment Period to enroll outside the Open Enrollment Period will soon lose, or was denied Medicaid or CHIP coverage, they may qualify for a Special Enrollment Period.