Medicare Premium Payment

The Medicare Premium Payment and the Medicare Part D State Contribution Payment Programs help to ensure that Medi-Cal is payer of last resort by paying for Medicare coverage when applicable.

What is Medicare?

Medicare is a federal health coverage program for the aged (persons age 65 or older), certain disabled individuals, and individuals with kidney failure.  Medicare coverage consists of three parts:  hospital insurance (Part A), medical insurance (Part B), and prescription drug coverage (Part D).

Medicare Premium Payment Program:

The Medicare Premium Payment allows Medi-Cal to pay Medicare Part A and/or Part B premiums for Medi-Cal beneficiaries and others who qualify for Medi-Cal under special programs, allowing Medi-Cal to defer costs for medical care to Medicare.

Premium Payment Handbook

Medicare Part D State Contribution Payments:

The Medicare Part D prescription drug program began in January 2006.  The state is required to pay a Part D premium payment for beneficiaries eligible for Medi-Cal.

Medicare Part B Buy-In Agreement:

The State of California participates in a buy-in agreement with the Centers for Medicare and Medicaid Services, whereby Medi-Cal automatically pays Medicare Part B premiums for all Medi-Cal beneficiaries who have Medicare Part B entitlement.

Statutory Authority: Social Security Act, Section 1843

To obtain the Medicare Buy-In Problem Report form, please call the number below.

Any questions regarding Medicare Operations should be directed to

toll free 1-800-952-5294