Medicare Part B Premium and Share of Cost

As of April 1, 2011, the Department of Health Care Services (DHCS) does not pay Medicare Part B premiums for individuals who have not met their share of cost in that month. The change to stop paying cost-avoidance Medicare Part B premiums for Medicare-eligible Medi-Cal applicants and/or members who have a share of cost (SOC) unless the SOC is met monthly.

As a result, the Social Security Administration (SSA) began deducting the Medicare Part B premium from the Social Security checks of affected members, starting with the checks issued in May 2011. A Medi-Cal member who meets their SOC in any month in which the Medicare Part B premium is deducted from their Social Security check is reimbursed that premium amount retroactively for that month in a subsequent Social Security check by SSA.

Medi-Cal members with zero or certified share of cost will continue to have their Part B premiums paid.

Individuals who are eligible for one of the Medicare Savings Programs (MSPs), such as Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI), are also eligible for payment of the Medicare Part B premium. To learn more about MSPs, please visit the DHCS Medicare-Savings-Programs-in-California webpage.
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For information about Medicare Part B buy-in, please visit the DHCS Medicare Premium Payment webpage. Submit questions about Medicare Part B buy-in to BuyIn@dhcs.ca.gov