Medicare Premium Assistance

Health Care

Children and Youth

Ability To Pay (ATP) Plan Child Health & Disability Prevention Program (CHDP) Children's No-Cost Medi-Cal Services Former Foster Care Children Healthy Families Kaiser Permanente Cares for Kids Medi-Cal Outreach District Outpatient Reduced-Cost Simplified Application (ORSA) Plan Regular No-Cost or Low-Cost Medi-Cal Services Women, Infants & Children Supplemental Nutrition Program (WIC)

Pregnant Women

Ability To Pay (ATP) Plan Access For Infants and Mothers (AIM) Pregnant-Only Medi-Cal Services Other Health Care Programs for Pregnant Women Outpatient Reduced-Cost Simplified Application (ORSA) Plan Regular No-Cost or Low-Cost Medi-Cal Services Women, Infants & Children Supplemental Nutrition Program (WIC)

Families

Ability To Pay (ATP) Plan Outpatient Reduced-Cost Simplified Application (ORSA) Plan Regular No-Cost or Low-Cost Medi-Cal Services Transitional Medi-Cal Programs

Aged - Blind - Disabled

Ability To Pay (ATP) Plan Long Term Care Medi-Cal Medicare Medi-Cal for Individual/Couple Living at Home Medicare Premium Assistance Programs Outpatient Reduced-Cost Simplified Application (ORSA) Plan Other Health Care Programs and Services Pickle Amendment Programs

Adults

Ability To Pay (ATP) Plan Other Free or Low-Cost Plans Outpatient Reduced-Cost Simplified Application (ORSA) Plan Regular No-Cost or Low Cost Medical Services

Special Health Problems

Ability To Pay (ATP) Plan California Children Services (CSS) Programs DDS Home & Community Based Services Dialysis or Total Parenteral Hyperalimentation (TPN) Programs Outpatient Reduced-Cost Simplified Application (ORSA) Plan Tuberculosis (TB) Program

Access Manual Estate Recovery Program Former Foster Care Children Healthy Way LA California Health Care Options (HCO) Immigrants We've Got You Covered

CalFresh General Relief Medi-Cal Office Locations

Medicare Premium Assistance Programs

The Medicare Premium Assistance Programs help pay for Medicare premiums to the aged, blind, and disabled individuals.

What services are offered?
The government pays part or all of your Medicare premium based on your income.

Who can be covered?
Medicare beneficiaries entitled to receive Part A Medicare.

How much does it cost?
Nothing.

Monthly Income
Family Size	Monthly income must be at or below:
1	$1,103
2	$1,485
3	$1,868
4	$2,250
5	$2,633
6	$3,016
7	$3,398
8	$3,780
9	$4,163
10	$4,545

Is there an income limit?
Yes, up to 135% of the Federal Poverty Level (FPL). To qualify for the program, the family's monthly income must be at or below the income limit specified for the family size. See the Monthly Income chart for details.

Property Limits
Family Size	Limit
1	$4,000
2	$6,000

Is there a property limit?
Yes, depending on the family size. See the Property Limits Chart for details.

Is citizenship or legal residency required?
Yes.

To file an application call (626) 854-4987.

Last Updated: May 2012

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