Short answer: Through the state: in Texas, Texas Health and Human Services (HHSC) decides which Medicare Savings Program a person qualifies for. An Extra Help application filed with Social Security also sends the person’s information to the state to start an MSP application unless the person opts out.
Medicare.gov: the Medicare Savings Programs are run by each state, the person applies through the state, and the state decides which program fits. In Texas that is HHSC, which administers QMB, SLMB, QI and QDWI under its Medicaid for the Elderly and People with Disabilities handbook.
Two practical routes:
- Apply with HHSC directly.
- Apply for Extra Help with Social Security; Medicare.gov says Social Security sends the information to the state to start an MSP application unless the person says not to on the Extra Help form.
Getting an MSP first has a bonus: QMB, SLMB and QI each make the person automatically eligible for full Extra Help (42 CFR 423.773(c)). Medicare.gov’s advice is to apply even if the person doesn’t think they qualify, and the local SHIP gives free application help.