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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


ADAP MM 2022-21
December 20, 2022


TO:
ADAP Enrollment Workers

SUBJECT:
Medicare Premium Payment Program (MPPP) and Medicare Part C Expansion

​ADAP MM 2022-21: Medicare Premium Payment Program (MPPP) and Medicare Part C Expansion


The purpose of this memo is to inform AIDS Drug Assistance Program (ADAP) enrollment workers that effective January 1, 2023 the California Department of Public Health (CDPH), Center for Infectious Diseases (CID), Office of AIDS (OA) has renamed the Medicare Part D Premium Payment (MDPP) program to the Medicare Premium Payment Program (MPPP); and effective January 1, 2023 MPPP will expand coverage to include Medicare Part C premiums & Medical Out-of-Pocket (MOOP) expenses.

Background

Medicare is the federal health insurance program for people who are aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. Different parts of Medicare help cover specific services:

  • Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Medicare Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
  • Medicare Part D helps cover the cost of prescription drugs (including many recommended shots or vaccines).
  • Medicare Part C, commonly referred to as Medicare Advantage, "bundles" Medicare Parts A, B, & D.

The MDPP program provides assistance to qualified Medicare eligible clients. Assistance includes coverage of Medicare Part D premiums, Medicare Part B MOOPs, and and Supplemental/Medigap premiums. 

Program Update

Effective January 1, 2023, the Medicare Part D Premium Payment (MDPP) program will be known as the Medicare Premium Payment Program (MPPP).

MPPP will expand program benefits to include coverage of Medicare Part C/Medicare Advantage Plan premiums, including MOOPs.

General Program Requirements

  • Active ADAP enrollment
  • Active Medicare Part C or Part D enrollment
  • Active MPPP eligibility

Medicare Premium Payment Program (MPPP) coverage includes:

  • Medicare Part D and/or Part C premium assistance
  • Part B MOOP assistance
  • Medigap/Supplemental plan premium assistance

Medicare Premium Payment Program (MPPP) coverage does NOT include:

  • Medicare Part B premium assistance
  • Dental or Vision premium assitance
  • Private employer plans

Documentation Requirements for Medicare Premium Payment Program Assistance (MPPP)

If already enrolled in the MDPP Program, now MPPP, no documentation is needed unless changes were made to either the Medicare Part D or Medicare Part C plan.

Existing clients eligible for Medicare Part C payments have had their January 2023 premiums paid with the November 2022 batch of Medicare payments.

If changes are made to either the Medicare Part D or Medicare Part C plan, an updated Client Attestation form (PDF) indicating MPPP is needed.

Scenarios:

Scenario 1:

An existing MDPP client with a Medicare Part C premium would like assistance with their Part C premiums.

No additional documentation is required. Pool Administrators Inc. (PAI) will automatically begin making the Medicare Part C premium payments in addition to the Medicare Part D payments.

Scenario 2:

A new client would like to enroll in MPPP.

The client must submit a new signed client attestation form with the appropriate box selected. Payments will begin on the first of the month that the attestation is submitted.

Scenario 3:

Client has a Part C premium, but no Part D premium.

The client can submit an attestation to enroll in MPPP for assistance with their Part C premium. There is no requirement to pay for Part D premiums if the client only has a Part C premium.

Scenario 4:

Client is deemed, or has 100% Low-Income Subsidy (LIS) for their Part D plan, but still has a premium for Part C.

MPPP can assist with the Part C premiums and MOOPs. The client will be responsible for any Part D premiums remaining after the subsidy is applied.

Scenario 5:

Client has changed Part C, Part D, or Medigap/Supplemental plan.

A new signed client attestation form is required to verify MPPP eligibility.

If you have any questions regarding the information provided in this memo, please contact your OA Advisor.

Thank you,

Sharisse Kemp E Signature 

Sharisse Kemp, MSW

ADAP Branch Chief

California Department of Public Health


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