If you’re on Medicare in San Antonio and living on a fixed income, there’s a program that could pay your entire Medicare Part B premium for you — that’s $202.90 a month, or $2,434.80 a year, back in your pocket. It’s called the Medicare Savings Program, it’s run here in Texas by HHSC (the Texas Health and Human Services Commission), and a huge number of seniors who qualify have never even heard of it.
This week is a good moment to check. The federal government’s one-time $90 Part B rebate is landing in bank accounts right now, and Medicare Open Enrollment starts October 15. Ninety dollars once is nice — but qualifying for the Medicare Savings Program can be worth that check twenty-seven times over, every single year. Here’s the plain-English version: the three programs, the 2026 income limits, and how to apply from Bexar County.
What the Medicare Savings Program actually is
The Medicare Savings Program (MSP) isn’t health insurance itself — it’s Texas paying part or all of your Medicare costs for you. You keep your Medicare; the state picks up the bills you’d normally have taken out of your Social Security check.
You need to be enrolled in Medicare Part A to qualify. Texas runs four MSP programs, and three of them cover the vast majority of people who apply:
The three programs, in plain English
QMB — Qualified Medicare Beneficiary. This is the big one. If your monthly income is up to $1,350 (single) or $1,824 (a couple), Texas pays your Part A and Part B premiums AND your deductibles, coinsurance, and copays. In practice, Medicare becomes nearly free for you. (Texas applies a small monthly income disregard, so these are the effective numbers — if you’re near the line, apply anyway and let HHSC do the math.)
SLMB — Specified Low-Income Medicare Beneficiary. If your monthly income is up to $1,616 (single) or $2,184 (couple), Texas pays your full Part B premium — the whole $202.90 a month.
QI — Qualifying Individual. If your monthly income is up to $1,816 (single) or $2,455 (couple), Texas also pays your Part B premium. Two catches: QI funding is first-come, first-served, and you must re-apply every year — so apply early in the year, not in December.
The savings limit (and what doesn’t count)
For all three programs, your countable savings and investments need to be under $9,950 if you’re single or $14,910 as a couple. Here’s the part that surprises most people: your home doesn’t count. Your car doesn’t count. Your furniture, clothes, and personal belongings don’t count. Plenty of San Antonio seniors who own their home outright and have one car still qualify — owning a home does not disqualify you.
The free prescription bonus: Extra Help
Here’s the part most guides bury at the bottom: if you’re approved for any Medicare Savings Program, you automatically qualify for “Extra Help” with your prescription drug costs. Extra Help can drop your Part D premium to nearly zero and your copays to a few dollars — on average worth about $5,000 a year in medication savings. No separate application needed; it comes with MSP.
What about that $90 rebate in the news?
Quick clarity, because it’s confusing: the $90 one-time payment going out this month is for people in Original Medicare who pay their own Part B premium. If you’re in a Medicare Advantage plan, you don’t get it. And if MSP (or Medicaid) already pays your premium, you don’t get it either — there’s no out-of-pocket premium for the rebate to offset. Don’t mistake the rebate for the real opportunity: $90 once versus $2,434.80 a year from MSP is no contest.
How to apply from San Antonio
- Online: YourTexasBenefits.com — this is where Texas takes MSP applications.
- Phone: call 2-1-1 Texas and ask for Medicare Savings Program help — they can point you to the nearest HHSC office or local helper.
- Free counseling: Texas HICAP at 1-877-839-2675, or the Texas Medicare Help Line at 800-252-9240 — free, unbiased Medicare counselors who will check whether you qualify before you file.
Applying is free. And unlike plan changes (which happen during Open Enrollment, Oct 15–Dec 7), MSP has no enrollment window — you can apply any month of the year.
Frequently asked questions
I already get Social Security — does that count against the income limit? Yes, Social Security counts as income, but Texas applies a small general income disregard and other exclusions. If you’re even close to the limits, apply anyway and let HHSC decide — borderline cases are decided in applicants’ favor more often than people expect.
Will owning my home disqualify me? No. Your primary home, one vehicle, and personal belongings are excluded from the savings limit.
I have a Medicare Advantage plan — can I still get MSP? Yes. MSP pays your Part B premium whether you have Original Medicare or a Medicare Advantage plan. (You just won’t get the one-time $90 rebate if you’re in Advantage.)
How long does approval take? Timelines vary by case — apply early, keep your phone on for HHSC’s call, and respond to any mail quickly. For QI especially, apply as early in the year as possible since it’s first-come, first-served.
Helpful links & phone numbers
- Medicare.gov — the official Medicare site: coverage, costs, and how enrollment works.
- Medicare Plan Compare — compare 2027 Medicare Advantage and Part D drug plans side by side, check your doctors and prescriptions, and enroll.
- 1-800-MEDICARE — free plan help by phone, 24 hours a day (except some holidays): 1-800-633-4227 (TTY: 1-877-486-2048).
- SHIP counselor locator (shiphelp.org) — find free, unbiased Medicare counseling near you. Counselors don’t sell plans.
- Texas HICAP (through Texas Health and Human Services) — free, local Medicare counseling for Texans — plan comparisons, billing problems, and appeals. Call the Texas Medicare Help Line: 1-800-252-9240.
- Social Security (ssa.gov) — Medicare enrollment questions and applying for Extra Help with drug costs: 1-800-772-1213.
Our free Apply for Me tool checks which programs you may qualify for — Medicare Savings Programs, Medicaid, SNAP, and more — and sends you a personalized guide.
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