Overview
The Medicare Premium Payment Program (MPPP) provides assistance to qualified Medicare eligible clients. Assistance includes coverage of Medicare Part D or Part C (Medicare Advantage) premiums, certain medical out-of-pocket (MOOP) costs, Medicare Supplemental Insurance (Medigap) premiums, standalone dental premiums, and bundled dental and vision premiums.
Medigap Premiums
Medigap is a supplemental health insurance policy that covers health care costs that traditional Medicare does not cover, such as co-payments, co-insurance, and deductibles. If you are enrolled in Medicare Parts A, B, and D, and have a Medigap premium of at least $1, you may be eligible to receive Medigap premium assistance through the MPPP.
The MPPP Medigap premium assistance covers the medical portion of the monthly premium as well as:
- "Extra" or "Innovative" benefits
- Dental premiums
- Vision premiums
MPPP Eligibility Requirements
- Be enrolled in CDPHās Medication Assistance Program
- Be enrolled in a Medicare Part D Prescription Drug Plan* or a Medicare Part C (Medicare Advantage) Plan
- Not be receiving 100 percent assistance from Medicare Extra Help/Full Low-Income Subsidy (LIS) (does not apply to Part C plans)
- Not be receiving full-scope Medi-Cal
*Please Note: Your plan must be from a participating Medicare Part D/C provider with a monthly premium. For a listing of all participating plans, please visit: Medicare - Find a Plan website. If you have any questions regarding Medicare Part D, you may contact Medicare directly at (800) 633-4227.
Medicare Open Enrollment
Open Enrollment for Original Medicare or plans with separate Medicare Part A and B is October 15, 2024 through December 7, 2024.
Open Enrollment for Medicare Part C (Medicare Advantage) plans is January 1, 2025 through March 31, 2025, or within the first three (3) months you get Medicare.
During this time, you may be eligible to make changes to your Medicare plan. For additional information, please visit the Medicare websiteāā.
MPPP Documentation Requirements
If you are already enrolled in the MPPP, you do not need to submit any documentation to CDPH unless you made changes to your Medicare Part D, Medicare Part C, Medigap, standalone Dental, or combined Dental and Vision plan.
If you made changes to your Medicare Part D or Part C plan, you must provide an updated Client Attestation form (CDPH8723) (PDF)ā indicating you are applying for MPPP. Updated Client Attestation forms may be submitted to your local Medication Assistance Program Enrollment Worker, or directly to the CDPH Medication Assistance Program.
If you made changes to your Medigap, standalone Dental, or combined Dental and Vision plan, you must provide an updated billing statement (including premium breakdown) to your local Medication Assistance Program Enrollment Worker, or directly to the CDPH Medication Assistance Program.
How to Submit Documents
Work with your local Medication Assistance Program Enrollment Worker to submit documents electronically (this is the fastest and preferred method), or
Email, fax, or mail the documents to CDPH:
Medicare Advantage Prescription Drug (MAPD) Plans
If you are enrolled in a MAPD plan, you must continue to pay your monthly Part B premium. MPPP cannot pay Part B Premiums.
āRefunds
If the Social Security Administration (SSA) automatically deducts your monthly Medicare Part D or your MAPD premium payments*, you will need to do the following:
- Confirm the CDPH MPPP has sent payment;**
- Contact your health plan to request direct billing, and
- Contact the SSA at (800) 772-1213, to stop the automatic deductions
*Clients enrolled in a MAPD plan may stop deductions for their Part D/C portion only.
**Payment confirmation to be mailed directly to client
Questions?
For questions about Medication Assistance Program eligibility and enrollment, please call: