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Medicare Premium Payment Program (MPPP) Clients

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, 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 eligible to receive Medigap premium assistance through the MPPP.

The MPPP Medigap premium assistance covers the medical, “extra,” and “innovative” portion of premiums only. Dental and vision costs are not covered by the MPPP.

MPPP Eligibility Requirements

  • Be enrolled in CDPH’s 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 PartC/Medicare Advantage 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, 2023 through December 7, 2023. 

Open Enrollment for Medicare Advantage Prescription Drug Plans/Medicare Part C, or plans with combined Medicare Part A, B, and D, is January 1, 2024 through March 31, 2024, 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 website​

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, or Medigap plan.

If you made changes to your Medicare Part D or Part C plan, you must provide an updated Client Attestation form (CDPH8723) (PDF)​ 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 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: 

  • Email:                            CDPHMedAssistFax@cdph.ca.gov
  • Fax:                                 (844) 421-8008
  • Mail:                                CDPH – Insurance Assistance
                                              P.O. Box 997426, MS 7704
                                              Sacramento, CA 95899

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.

​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 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: 

  • Your local Medication Assistance Program Enrollment Worker, or 
  • The Medication Assistance Program Client Services call center at (844) 421-7050. Client Services staff are available Monday–Friday, 8 A.M.–5 P.M. (excluding holidays).

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