This letter corrects the date that affected beneficiaries will see the Part B premium deducted from their Social Security checks. Checks will be affected December, 2008, not November as stated in ACWDL 08-48. Counties are also reminded that they can suggest the 250% Working Disabled Program to beneficiaries as a program in which beneficiaries are not responsible for the Part B premium. DHCS sent a letter in October, 2008 alerting beneficiaries that they would have to begin paying the Part B premium; unfortunately they sent this letter to beneficiaries who are MSP eligible too. In November they will send a letter to the same group of people with more information about the Part B premium, MSPs, SOC, and the 250%WDP. Enclosed in this ACWDL is a copy of the letter SS will be sending to beneficiaries regarding the Part B premium. [Download]

This ACWDL puts part of budget trailer bill AB 1183 into effect by eliminating the state buy-in of Medicare Part B premiums for beneficiaries with a share of cost over $500 until or unless the SOC is met on a monthly basis. Some details:
-The change is effective 10/1/08 and will affect SS checks received in November (But not really, See ACWDL 08-48E)
-People eligible for a Medicare Savings Program will still have their Part B payments paid by the govt. Counties must determine MSP eligibility immediately for all Medi-Medis with or without a SOC. (See ACWDL 08-21)
-Beneficiaries who have to pay the Part B premium can disenroll from Medicare Part B with no negative affect on Medi-Cal eligibility, 22 CCR 50763(a)(1) only requires beneficiaries to apply for other health care coverage when no cost is involved.
-When beneficiaries begin to pay their own premiums Counties must recalculate the SOC deducting the Part B premium. They will receive a NOA letting them know why the SOC is being reduced and that they can disenroll form Medicare Part B and what some of the consequences of that will be.
-If a beneficiary pays the Part B premium and that deduction brings the SOC below $500 or makes them eligible for A&DFPL DHCS will pay the premium for that month retroactively, if the SOC then goes back up because the Part B premium is no longer being deducted the County needs to send a NOA.
-Reimbursement from SSA will be treated as property in the month of receipt
-Counties are not to predict buy-ins [Download]