Qhov Kev Pab Them Nqi Medicare Premium, tseem hu ua Medicare Buy-In, tso cai rau Medi-Cal them cov nqi Medicare Part A thiab/lossis Part B rau cov tswv cuab Medi-Cal uas tsim nyog thiab cov neeg uas tsim nyog rau cov kev pab cuam Medi-Cal uas pab them cov nqi Medicare. Qhov kev pab cuam no ua rau Medi-Cal muaj peev xwm ncua cov nqi kho mob rau Medicare thaum twg tsim nyog.​​ 

Medicare yog dab tsi?​​ 

Medicare yog ib qho kev pab cuam pov hwm kev noj qab haus huv hauv tebchaws rau cov neeg laus (cov neeg muaj hnub nyoog 65 xyoos lossis laus dua), qee cov neeg hluas uas muaj kev tsis taus, thiab cov neeg uas muaj Kab Mob Raum Theem Kawg (ESRD). Kev them nqi kho mob Medicare los ntawm lub xeev txoj kev pab cuam yuav khoom yuav muaj cov hauv qab no:​​ 

• Tshooj A - Kev pov hwm kho mob hauv tsev kho mob (HI)​​ 
• Tshooj B - Kev pov hwm kho mob ntxiv (SMI)​​ 
• Ntu D - Kev them nqi tshuaj (kev them nyiaj pab txhawb nqa)​​ 

Cov tswv cuab tsis tuaj yeem muaj kev pab them nqi Medicare Tshooj A yog tsis muaj kev pab them nqi Medicare Tshooj B. Cov tswv cuab yuav tsum muaj kev pab them nqi Tshooj A lossis Tshooj B thiaj li tsim nyog tau txais Tshooj D.​​ 

Tshooj Ib Daim Ntawv Pom Zoo Yuav​​ 

Txij li thaum Lub Ib Hlis Ntuj hnub tim 1, 2025, Lub Xeev California koom nrog daim ntawv cog lus yuav khoom nrog Lub Chaw rau Medicare thiab Medicaid Services (CMS), uas Medi-Cal them cov nqi them rau Medicare Part A, kev them nqi sib koom, thiab cov nqi deductible rau cov tswv cuab Medi-Cal uas tsim nyog uas:​​ 

• Tau cuv npe rau hauv Qhov Kev Pabcuam Tsim Nyog Medicare (QMB), thiab​​ 
• Muaj Medicare Part B txoj cai raws li qhia los ntawm Social Security Administration (SSA).​​ 

Medi-Cal cov tswv cuab uas muaj Part B nkaus xwb, thiab tsis yog Part A, muaj Medi-Cal kev pab them nqi kho mob rau cov neeg mob nyob rau hauv thiab lwm yam kev pab cuam Part A. Raws li Tshooj Ib Daim Ntawv Pom Zoo Yuav, rau Medi-Cal cov tswv cuab uas tsim nyog tau txais kev pab Medicare, Medicare yuav muab kev pab them nqi kho mob rau tsev kho mob thiab lwm yam kev pab them nqi kho mob hauv Medicare Part A.​​ 

Txoj Cai Lij Choj: Social Security Act, Tshooj 1818​​ 

DHCS tau tshaj tawm cov ntawv ceeb toom rau cov tswv cuab uas tsim nyog rau Tshooj A txij li Lub Ib Hlis 1, 2025. DHCS kuj tau qhia rau Medi-Cal Managed Care Plans (MCPs) kom txhawb nqa cov tswv cuab kom tau txais kev kho mob thaum lub Ib Hlis Ntuj xyoo 2025, kev hloov pauv, tshwj xeeb tshaj yog rau cov tswv cuab uas tau txais kev pabcuam pw hauv tsev kho mob uas yuav raug them los ntawm Medicare Part A.​​ 

For member questions regarding access to care, please contact your MCP. For member questions regarding Medicare eligibility, please contact your local Social Security Administration (SSA) office or the Health Insurance Counseling & Advocacy Program (HICAP).​​ 

Cov ntaub ntawv ntxiv txog Part A Buy-In tuaj yeem nrhiav tau siv qhov txuas hauv qab no:​​ 

Tshooj Ib Cov Lus Nug Nquag Nug (FAQs)​​ 

Medicare Tshooj B Daim Ntawv Pom Zoo Yuav​​ 

The State of California participates in a buy-in agreement with CMS, whereby Medi-Cal automatically pays Medicare Part B premiums for eligible Medi-Cal members who have Medicare Part B entitlement as reported by SSA.​​ 

Statutory Authority: Social Security Act, Section 1843​​ 

Medicare Part D Kev them nyiaj rau lub Xeev​​ 

Cov nqi them rau cov tshuaj uas tau sau tseg tau hloov ntawm Medicaid mus rau Medicare pib thaum Lub Ib Hlis 2006 vim yog Txoj Cai Tshuaj, Kev Txhim Kho thiab Kev Ua Kom Niaj Hnub Nimno (MMA) xyoo 2003 ntawm Medicare, uas tau tsim qhov kev pab cuam tshuaj Medicare Part D. Lub xeev yuav tsum tau them tus nqi them rau Ntu D rau cov tswv cuab Medi-Cal uas tsim nyog tau txais kev pab them nqi Ntu A lossis Ntu B.​​ 

Txoj Cai Lij Choj: Medicare Tshuaj Tshuaj, Txhim Kho thiab Kho Kom Zoo Dua Tshiab 2003​​ 

Cov kev pab cuam them nqi Medicare Premium thiab Medicare Part D State Contribution Payment pab kom ntseeg tau tias Medi-Cal yog tus them nqi kawg, uas pab kom ntseeg tau tias cov peev txheej Medi-Cal raug siv kom raug thiab raug tseg rau cov nqi uas Medicare tsis them.​​ 

Phau Ntawv Qhia Txog Kev Yuav Khoom Hauv Xeev - Ntu A thiab Ntu B Cov lej ua lag luam​​ 

Cov lej ua lag luam yuav khoom muab ib txoj hauv kev sib txuas lus luv luv thiab meej ntawm CMS thiab Lub Xeev California. Feem ntau cov lej ua lag luam tsis tas yuav tsum muaj kev nqis tes ua ntxiv ntawm Lub Xeev; txawm li cas los xij, muaj qee zaum uas kev nqis tes ua ntxiv los ntawm Lub Xeev yog qhov tsim nyog. Saib cov ntaub ntawv PDF hauv qab no kom paub txog cov lej pauv nyiaj.​​ 

Part A Kev Yuav-Nyob Hauv thiab Ntu B Yuav-hauv/Pab Pawg Tus Neeg Them Nqi Them Nqi (PDF)
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Daim Ntawv Qhia Txog Teeb Meem Kev Pab Cuam Yuav Khoom Hauv Medicare Hauv Xeev (daim ntawv sau tau hauv online)​​ 

Thov siv daim foos hauv qab no los tshaj tawm qhov teeb meem kev yuav khoom ntawm Medicare rau Chav Yuav Khoom ntawm DHCS. Daim ntawv no yog rau cov koom haum hauv xeev, lub nroog, thiab tsoomfwv tebchaws xwb thiab tsis yog rau cov pej xeem sawv daws. Cov tswv cuab uas muaj teeb meem kev yuav khoom yuav tsum tiv tauj lawv tus neeg ua haujlwm tsim nyog hauv nroog kom tau kev pab.​​ 

Lub Xeev Medicare Daim Ntawv Qhia Txog Kev Yuav Khoom​​ 

Rov qab mus rau nplooj ntawv tseem ceeb ntawm TPLRD​​