Medicare Part D Premium Payment (MDPP) Assistance
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.
To be eligible for Medicare Part D premium assistance, clients must:
- Be enrolled in a Medicare Part D Prescription Plan
- Not be receiving 100% assistance from Medicare's Extra Help/Full Low Income Subsidy (LIS)
- 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.
- 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:
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.