Why did California stop paying Medicare Part B?

Asked by: Audreanne Johnston  |  Last update: January 14, 2026
Score: 4.9/5 (12 votes)

As part of the effort to resolve the severe shortfall in the California budget, the Legislature and Governor adopted state law that ends Medi-Cal payments of the Medicare Part B premiums for some Medi-Cal beneficiaries as of November 1.

Why is the state of California not paying Medicare Part B?

This is because DHCS will not pay your Part B premium in months when: Your Medi-Cal share-of cost (SOC) is over $500 • AND • Your medical expenses are lower than your SOC. Your SOC is the amount that you must pay or promise to pay for medical expenses before Medi-Cal will pay.

Why is Medicare no longer paying my part B?

There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.

Does California pay for Medicare Part B?

The Medicare Premium Payment Program, also known as Medicare Buy-In, allows Medi-Cal to pay Medicare Part A and/or Part B premiums for Medi-Cal members -and those who qualify for Medi-Cal through special programs. This program enables Medi-Cal to defer medical costs to Medicare where appropriate.

Does everyone pay $170 for Medicare Part B?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

How To QUIT MEDICARE Part B

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How do I avoid paying Medicare Part B?

You may refuse Part B without penalty if you have creditable coverage, but you have to do it before your coverage start date. Follow the directions on the back of your Medicare card if you want to refuse Part B.

Do all seniors pay for Medicare Part B?

Part B is a voluntary program that requires the payment of a monthly premium for all parts of coverage. Eligibility rules for Part B depend on whether a person is eligible for premium-free Part A or whether the individual has to pay a premium for Part A coverage.

Is anyone exempt from paying for Medicare Part B?

Enrollees who have Medicaid, employer-sponsored health coverage, or retiree health benefits from an employer generally don't have to pay the full Medicare Part B deductible, as the other coverage picks up some or all of the cost (this varies depending on the plan).

Can you have both Medicare and Medi-Cal in California?

Can a person have both Medicare and Medi-Cal? Yes. Sometimes that's callled “Medi-Medi”, or “dual eligible.” Medicare is billed first for services and Medi-Cal is billed last. Medical providers are famliar with “Medi-Medis."“

Does CalSTRS pay for Medicare Part B?

You will have to pay the Medicare Part B premium. At your request, CalSTRS can deduct Medicare Part B premiums from your monthly retirement benefit and forward the payment to the Centers for Medicare and Medicaid Services, the federal agency that administers Medicare.

Does Medicare pay 100% on Part B?

Medicare Part B coinsurance

Coinsurance is a cost-sharing term that means insurance pays a percentage and you pay a percentage. With Medicare Part B, you pay 20 percent of the cost for the services you use. So if your doctor charges $100 for a visit, then you are responsible for paying $20 and Part B pays $80.

Why is Medicare Part B so expensive?

Medicare costs, including Part B premiums, deductibles and copays, are adjusted based on the Social Security Act. And in recent years Part B costs have risen. Why? According to CMS.gov, “The increase in the Part B premiums and deductible is largely due to rising spending on physician-administered drugs.

How to get Medicare Part B without penalty?

If you've been covered by an active employer group health plan (either yours or your spouse's) since turning 65, and it ended within the last 8 months, you can enroll in Part B without any penalty. This is considered a “Special Enrollment Period.”

Do poor people pay for Medicare Part B?

Specified Low-Income Medicare Beneficiary (SLMB) Program— Helps pay Part B premiums only. Qualifying Individual (QI) Program—Helps pay Part B premiums only. You must apply each year for QI benefits, and the applications are granted on a first-come first-served basis.

What are the alternatives to Medicare Part B?

Part C (Medicare Advantage)

Part C is known as Medicare Advantage. It's an alternative to Parts A and B that bundles several coverage types, including Parts A, B, and usually D. It may also include: Vision.

Do I need Medicare Part B if I have Medi-Cal?

If you qualify for full Medi-Cal (Medi-Cal without a share of cost (SOC)), Medi-Cal will also cover your Medicare Part A and B deductibles and copayments, and pay your monthly Medicare Part B premium.

Does Kaiser accept Medicare patients in California?

In California, Hawaii, and Washington, Kaiser Permanente is an HMO plan with a Medicare contract. In Colorado, Kaiser Permanente is an HMO, HMO-POS and PPO plan with Medicare contracts.

Is California no longer paying Medicare Part B premiums?

As part of the effort to resolve the severe shortfall in the California budget, the Legislature and Governor adopted state law that ends Medi-Cal payments of the Medicare Part B premiums for some Medi-Cal beneficiaries as of November 1.

Can I drop my employer health insurance and go on Medicare Part B?

Once you stop working (or lose your health insurance, if that happens first) you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare (or add Part B to existing Part A coverage).

Who qualifies for an extra $144 added to their Social Security?

To qualify to get $144 added back to your Social Security check, you can enroll in a Medicare Advantage plan that offers a Part B premium reduction or giveback benefit.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

Is Medicare Part B mandatory?

Part B is optional. Part B helps pay for covered medical services and items when they are medically necessary. Part B also covers some preventive services like exams, lab tests, and screening shots to help prevent, find, or manage a medical problem.