An official State of Texas website.
Revision 24-3; Effective Sept. 1, 2024
The Qualified Medicare Beneficiary (QMB) program pays Medicare premiums, deductibles and coinsurance for people who meet all eligibility requirements.
To be eligible for QMB coverage, a person must:
- be entitled to benefits under Medicare Part A or enrolled in Medicare Part B-ID; and
- meet income and resources requirements.
The income limits for QMB are updated annually based on 100%of the federal poverty level (FPL).
The resource limits are updated annually based on the consumer price index (CPI).
The person must provide proof of Medicare Part A entitlement or enrollment in Medicare Part B-ID. Proof may include a Medicare card or an enrollment letter from the Social Security Administration (SSA) showing current entitlement.
If the person does not have proof of entitlement to Part A or enrollment in Part B-ID, refer them to SSA if they:
- are 65;
- have an established disability, as determined by SSA; or
- have end-stage renal disease.
A person receiving Medicaid may also be eligible for QMB benefits if they meet the requirements of this section, including the following:
- people of any age residing in a state supported living center;
- people 65 or older residing in an institution for mental diseases (IMD), also known as a state hospital; and
- people of any age residing in an intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID).
Related Policy
Medicare Savings Program Information, Appendix IX
Qualified Medicare Beneficiary (QMB), A-8100
Medicare Savings Programs Overview, Q-1000
MSP Resource Limits, Q-1300
MSPs and Medicare Part B-ID, Q-1500
QMB Income Limits, Q-2500
QMB Medical Effective Date, Q-2700
Qualified Disabled and Working Individuals (QDWI) – MC-QDWI, Q-6000