Welcome to the State of California 

Office of AIDS

Medicare Part D Premium Payment Program

The Medicare Part D Premium Payment Program pays only Part D insurance premiums for persons living with HIV/AIDS who are enrolled in both a Medicare Part D prescription drug plan and the AIDS Drug Assistance Program (ADAP).

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 www.Medicare.gov.


Quick Links:



To be eligible for Medicare Part D Premium Assistance, you must:

  • Be a resident of California
  • Have an HIV/AIDS diagnosis
  • Be at least 18 years old
  • Be enrolled in ADAP
  • Be enrolled in a Medicare Part D Prescription Plan*
  • Not be receiving 100% assistance from Medicare’s Extra Help/Full Low Income Subsidy (LIS)
  • Not be receiving Full Scope Medi-Cal

*PLEASE NOTE: Your Medicare Part D Prescription Plan must be participating in the Medicare Part D Premium Payment Program.


Back to top


Required Documents and Blank Application Forms

2016 Medicare Part D application packet:


To obtain a 2015 Medicare Part D Premium Payment Program application packet please contact us at (844) 421-7050 or by e-mail at IASPartD@cdph.ca.gov. Please note that by submitting a complete 2015 application packet, you are applying for assistance only for the month that the complete application is received by OA through the end of 2015. To obtain coverage for 2016, you MUST submit a complete 2016 application packet.



Back to top


How to apply for the Medicare Part D Premium Payment Program

On November 15 of each year, OA accepts applications for the following year, but applications may be submitted anytime for the current year. OA will pay premiums for an entire calendar year for those completed and approved applications received by February 28. Medicare Part D Premium Payment applications received after February 28th will be processed the month which they were received. All incomplete applications will be denied.

You can apply directly to the Medicare Part D Premium Payment Program by faxing or mailing a completed application to the Office of AIDS. Submit completed forms to OA at:

Insurance Assistance Section
California Department of Public Health
PO Box 997426, MS 7704
Sacramento, CA95899-7426 Or by fax
or email here: (916) 440-5494 or


For more assistance with the Medicare Part D program

You may call 1 (844) 421-7050 or email IASPartD@CDPH.CA.GOV for additional assistance.


Back to top


You may also be interested in:


Office of AIDS Home


Last modified on: 11/4/2015 10:16 AM