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

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:

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.