All County Welfare Director’s Letter (ACWDL) 01-18 dated March 16, 2001 provided questions and answers regarding the Aged and Disabled Federal Poverty Level (A&D FPL) program. In the answer to question 8 of that ACWDL, it was stated that a person could pay a health care premium to qualify for the A&D FPL program.

The CDHS has determined that this answer only applies to health insurance premiums, and not to the Medicare Part B premium. That is, after the first two months on Medi-Cal, per Title 22 CCR § 50773, the CDHS makes the payment of the Medicare Part B buy-in on behalf of the Medi-Cal beneficiary. This payment is made per an agreement between the CDHS and the Social Security Administration.

Under the current agreement between the CDHS and the Social Security Administration, the CDHS may not permit a Medi-Cal recipient to opt out of the Medicare Part B buy-in on an individual basis.