Overview
The Medicare Part D Premium Payment (MDPP) Program provides assistance to qualified Medicare eligible clients. Assistance includes coverage of Medicare Part D premiums, certain Medical Out-Of-Pocket (MOOP) costs, and Supplemental/Medigap 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 able to receive Medigap premium assistance through the MDPP Program.
The MDPP Medigap premium assistance covers the medical, "extra", and "innovative" portion of premiums only. Dental and vision costs are not covered by the MDPP Program.
MDPP Eligibility Requirements
- Be enrolled in CDPHās Medication Assistance Program
- Be enrolled in a Medicare Part D Prescription Drug Plan*
- Not be receiving 100 percent assistance from Medicare Extra Help/Full Low-Income Subsidy (LIS)
- Not be receiving full-scope Medi-Cal
*Please Note: Your plan must be from a participating Medicare Part D provider with a Part D 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 seperate Medicare Part A and B is October 15, 2022 through December 7, 2022.
Open Enrollment for Medicare Advantage Prescription Drug Plans/Medicare Part C, or plans with combined Medicare Part A, B, and D, is January 1, 2023 through March 31, 2023.
During this time, you may be eligible to make changes to your Medicare plan. For additional information, please visit: www.medicare.gov.
MDPP Documentation Requirements
If you are already enrolled in the MDPP Program, you do not need to submit any documentation to CDPH unless you made changes to your Medicare Part D or Medigap plan.
If you made changes to your Medicare Part D plan, you must provide an updated Client Attestation form (PDF) indicating you are applying for MDPP. 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 plan, you must provide an updated billing statement 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 medical and outpatient (Part B and C) premiums. MDPP cannot pay these premiums and only covers the discernable Part D portion.
Please note: You should verify your monthly premium amount with your health plan and pay the exact amount. Otherwise, you may be terminated from the plan.
Refunds
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 MDPP Program 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 portion only.
**Payment confirmation to be mailed directly to client
Questions?
For questions about Medication Assistance Program eligibility and enrollment, please call: