For Medicare beneficiaries, their state of residence can have a substantial impact on the care they receive and how they pay for that care when and after they turn 65. If you live in Texas and have questions on Medicare, then reaching out to a Medicare broker in Texas should be your next step to get the precise answers. Today, in this post, we will provide you with an overview of how Texas’ regulations and policies affect the cost you pay for Medicare.
Does Texas help Medicare beneficiaries pay their Medicare premium?
Those who struggle to pay the cost of Medicare premium might be eligible to get help through a Medicare Savings Program (MSP). In Texas, this program can help you pay for:
- Medicare Part B premium
- Medicare Part A and B cost-sharing
- Part A premiums in some cases
Medicare Beneficiaries are typically divided into the following three categories:
1. Qualified Medicare Beneficiary (QMB)
- Monthly income limit for single: $1,063
- Monthly income limit for married: $1,437
The QMB program pays Part A and B cost-sharing, Part B premium, and also pays Part A premiums if a beneficiary owes them.
2. Specified Low-Income Medicare Beneficiary (SLMB)
- Monthly income limit for single: $1,276
- Monthly income limit for married: $1,724
The SLMB program pays Part B premiums for this group of beneficiaries.
3. Qualified Individuals (QI)
- Monthly income limit for single: $1,436
- Monthly income limit for married: $1,940
The QI program helps beneficiaries by paying their Part B premiums.
Note: The MSP asset limits for each type of beneficiary are $7,860 if single and $11,800 if married.
What are the eligibility criteria for Medicaid for the aged, blind, and disabled in Texas?
Though Original Medicare covers a vast range of services like hospitalization, physician services, and prescription drugs, it doesn’t cover various important services such as vision and dental benefits. But those beneficiaries who are eligible for Medicaid because of their income can get coverage for additional services, given that they are enrolled in regular Medicaid for the Aged, Blind, and Disabled (ABD).
In Texas, Medicaid ABD, also known as Medicaid for the Elderly and People with Disabilities, provides coverage for dental care only in case of emergencies. Besides, it also covers the cost of eye exams and eyeglasses or contacts every 2 years.
Income Criterion: $783 a month for singles and $1,175 a month for married
Since this income limit is also than QMB, it means that Medicaid ABD enrollees in Texas are also eligible for QMB benefits, and they can confirm it with their Medicaid office. In the case of Medicaid ABD, the asset limit is $2,000 for singles and $3,000 for married. For those who need long-term care, most of it is not covered by Medicare. Medicaid can help fill this gap in Medicare coverage for long-term care. However, its complex eligibility rules can make it quite difficult for beneficiaries to get benefits. In such cases, a Medicare broker in Texas is the best choice to find the right Medicare option for you and solve the issues you have with the highest efficiency.