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Medicare and Medicaid Dual Eligibility in District of Columbia 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in District of Columbia: Key Facts

Dual Eligible Population	Approximately 12% of District of Columbia Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
District of Columbia Medicaid Agency	DC Department of Health Care Finance
Phone	202-442-5988

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In District of Columbia, approximately 12% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in District of Columbia

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in District of Columbia that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in District of Columbia

Full dual eligible beneficiaries in District of Columbia receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by District of Columbia Medicaid program)

How to Apply for Dual Eligibility in District of Columbia

To apply for Medicaid in District of Columbia and potentially qualify for dual eligibility, contact the DC Department of Health Care Finance at 202-442-5988. You can also apply online through District of Columbia’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in District of Columbia

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In District of Columbia, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Wyoming 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Wyoming: Key Facts

Dual Eligible Population	Approximately 7% of Wyoming Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Wyoming Medicaid Agency	Wyoming Department of Health
Phone	307-777-6964

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Wyoming, approximately 7% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Wyoming

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Wyoming that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Wyoming

Full dual eligible beneficiaries in Wyoming receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Wyoming Medicaid program)

How to Apply for Dual Eligibility in Wyoming

To apply for Medicaid in Wyoming and potentially qualify for dual eligibility, contact the Wyoming Department of Health at 307-777-6964. You can also apply online through Wyoming’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Wyoming

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Wyoming, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Wisconsin 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Wisconsin: Key Facts

Dual Eligible Population	Approximately 11% of Wisconsin Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Wisconsin Medicaid Agency	Wisconsin Department of Health Services
Phone	608-266-1865

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Wisconsin, approximately 11% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Wisconsin

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Wisconsin that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Wisconsin

Full dual eligible beneficiaries in Wisconsin receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Wisconsin Medicaid program)

How to Apply for Dual Eligibility in Wisconsin

To apply for Medicaid in Wisconsin and potentially qualify for dual eligibility, contact the Wisconsin Department of Health Services at 608-266-1865. You can also apply online through Wisconsin’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Wisconsin

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Wisconsin, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in West Virginia 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in West Virginia: Key Facts

Dual Eligible Population	Approximately 14% of West Virginia Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
West Virginia Medicaid Agency	West Virginia Bureau for Medical Services
Phone	304-558-1700

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In West Virginia, approximately 14% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in West Virginia

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in West Virginia that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in West Virginia

Full dual eligible beneficiaries in West Virginia receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by West Virginia Medicaid program)

How to Apply for Dual Eligibility in West Virginia

To apply for Medicaid in West Virginia and potentially qualify for dual eligibility, contact the West Virginia Bureau for Medical Services at 304-558-1700. You can also apply online through West Virginia’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in West Virginia

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In West Virginia, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Washington 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Washington: Key Facts

Dual Eligible Population	Approximately 11% of Washington Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Washington Medicaid Agency	Washington Health Care Authority
Phone	360-725-1000

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Washington, approximately 11% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Washington

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Washington that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Washington

Full dual eligible beneficiaries in Washington receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Washington Medicaid program)

How to Apply for Dual Eligibility in Washington

To apply for Medicaid in Washington and potentially qualify for dual eligibility, contact the Washington Health Care Authority at 360-725-1000. You can also apply online through Washington’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Washington

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Washington, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Virginia 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Virginia: Key Facts

Dual Eligible Population	Approximately 13% of Virginia Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Virginia Medicaid Agency	Virginia Department of Medical Assistance Services
Phone	804-786-7933

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Virginia, approximately 13% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Virginia

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Virginia that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Virginia

Full dual eligible beneficiaries in Virginia receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Virginia Medicaid program)

How to Apply for Dual Eligibility in Virginia

To apply for Medicaid in Virginia and potentially qualify for dual eligibility, contact the Virginia Department of Medical Assistance Services at 804-786-7933. You can also apply online through Virginia’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Virginia

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Virginia, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Vermont 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Vermont: Key Facts

Dual Eligible Population	Approximately 8% of Vermont Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Vermont Medicaid Agency	Vermont Department of Vermont Health Access
Phone	802-879-5900

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Vermont, approximately 8% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Vermont

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Vermont that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Vermont

Full dual eligible beneficiaries in Vermont receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Vermont Medicaid program)

How to Apply for Dual Eligibility in Vermont

To apply for Medicaid in Vermont and potentially qualify for dual eligibility, contact the Vermont Department of Vermont Health Access at 802-879-5900. You can also apply online through Vermont’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Vermont

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Vermont, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Utah 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Utah: Key Facts

Dual Eligible Population	Approximately 8% of Utah Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Utah Medicaid Agency	Utah Department of Health and Human Services
Phone	801-538-6155

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Utah, approximately 8% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Utah

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Utah that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Utah

Full dual eligible beneficiaries in Utah receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Utah Medicaid program)

How to Apply for Dual Eligibility in Utah

To apply for Medicaid in Utah and potentially qualify for dual eligibility, contact the Utah Department of Health and Human Services at 801-538-6155. You can also apply online through Utah’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Utah

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Utah, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Texas 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Texas: Key Facts

Dual Eligible Population	Approximately 17% of Texas Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Texas Medicaid Agency	Texas Health and Human Services Commission
Phone	512-424-6500

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Texas, approximately 17% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Texas

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Texas that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Texas

Full dual eligible beneficiaries in Texas receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Texas Medicaid program)

How to Apply for Dual Eligibility in Texas

To apply for Medicaid in Texas and potentially qualify for dual eligibility, contact the Texas Health and Human Services Commission at 512-424-6500. You can also apply online through Texas’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Texas

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Texas, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026

Medicare and Medicaid Dual Eligibility in Tennessee 2026: Income Limits, Benefits & How to Apply

Dual Eligibility in Tennessee: Key Facts

Dual Eligible Population	Approximately 14% of Tennessee Medicare beneficiaries
QMB Income Limit (Individual)	$1,255/month (100% FPL)
SLMB Income Limit (Individual)	$1,694/month (120% FPL)
Tennessee Medicaid Agency	Tennessee Division of TennCare
Phone	615-507-6100

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Tennessee, approximately 14% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Tennessee

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Tennessee that helps pay your Medicare costs. There are four MSP levels:

Program	Individual Income Limit	What It Pays
Qualified Medicare Beneficiary (QMB)	$1,255/month	Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB)	$1,694/month	Part B premium only
Qualifying Individual (QI)	~$1,800/month	Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI)	~$4,615/month	Part A premium only

Benefits of Full Dual Eligibility in Tennessee

Full dual eligible beneficiaries in Tennessee receive:

$0 Medicare premiums — Medicaid pays your Part A and Part B premiums
$0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
Additional services — Dental, vision, hearing, and transportation (varies by Tennessee Medicaid program)

How to Apply for Dual Eligibility in Tennessee

To apply for Medicaid in Tennessee and potentially qualify for dual eligibility, contact the Tennessee Division of TennCare at 615-507-6100. You can also apply online through Tennessee’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Tennessee

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Tennessee, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

August 3, 2026