The Medicare Part D Premium Payment Program (MDPP) pays Part D and Medigap insurance premiums for persons living with HIV/AIDS who are enrolled in the AIDS Drug Assistance Program (ADAP) and a Medicare Part D prescription drug plan. Individuals that are enrolled in MDPP are also eligible for the medical out-of-pocket (MOOP) cost benefit, which covers outpatient MOOP costs that count towards the client's health insurance policy's annual out of pocket maximum.

For information about the Medicare Part D program and links to important tools for Part D prescription plan selection call 1-800-Medicare (1-800-633-4227) or visit the Medicare website. 

Eligibility Criteria 

To be eligible for Medicare Part D premium assistance, clients must:

• Be enrolled in ADAP (see ADAP eligibility criteria)

• Be enrolled in a Medicare Part D Prescription Plan
• Not be receiving 100% assistance from Medicare's Extra Help/Full Low Income Subsidy (LIS)

MDPP Benefits

• Medicare Part D premium maximum:  $1,938 per month.
• Medigap premium maximum:  $1,938 per month.
• Premium payments are sent directly to the health plan on a monthly basis.
• MDPP pays for outpatient MOOP costs that count towards the medical insurance plan's annual out-of-pocket maximum.
• MOOP reimbursements are sent directly to the rendering provider.

How to Apply

Clients have two options:

1.        Contact an ADAP enrollment worker. An enrollment worker can help clients with:

• Submitting the required documentation to ADAP and
• Indicating in the ADAP Enrollment System that the client would like Medicare Part D premium payment assistance.

To find an enrollment worker near you, access the ADAP Enrollment Site Locator.

2.        Self-enrollment:

• Complete the following sections of the ADAP Application (PDF):
• Section 1 (Profile), Section 6 (Insurance), Section 7 (Read and Sign) 
• Pages 10 and 11 (ADAP Consent Form) 
• Complete an ADAP Fax Submission Coversheet (PDF)
• If requesting premium assistance with a Medigap plan, collect the most recent billing statement.
• Submit all of the above to ADAP/MDPP using one of these methods:
• Fax to (844) 421-8008
• Email to CDPHMedAssistFax@cdph.ca.gov
• Standard mail to:
  

California Department of Public Health

Insurance Assistance Section

P.O.  Box 997426, MS 7704

Sacramento, CA 95899-7426

If clients or enrollment workers are having difficulty accessing enrollment materials or need additional assistance, they should contact the ADAP call center at (844) 421–7050 or contact a Medicare Part D Advisor.