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Guide to LIS Mailings from CMS, Social Security and Plans

SUMMER AND FALL 2008


Date Sender Mailing/Color Main Message Consumer Action
Mid-May Social Security Social Security LIS and MSP Outreach Letter (SSA Pub. Forms L446, L447 & L448) Informs people who may be eligible for Medicare Savings Programs about the MSPs and the extra help available for Medicare prescription drug plan costs. • If you think you qualify for extra help, you should apply.
• For more information about the extra help or if you want to apply, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Early August CMS LIS Direct Marketing Cost-Effectiveness Study Mailing Informs 20,000 randomly selected beneficiaries about the extra help as part of a special pilot study, and encourages them to apply. • If you think you qualify for extra help, you should apply.
• For more information about the extra help or if you want to apply, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Late August Social Security Social Security Letter to Review Eligibility for Extra Help (SSA Form No 1026) Informs people selected for review that they should see if they continue to qualify for extra help in 2009. Includes an "Income and Resources Summary" sheet. If you receive this letter, you must return the enclosed form in the enclosed postage paid envelope within 30 days or your extra help may end.
September CMS Loss of Deemed Status Letter (Pub. No. 11198) (GREY Letter) Informs people that they no longer automatically qualify for extra help as of January 1, 2009. Apply for extra help through Social Security (application and postage paid envelope enclosed) or a State Medical Assistance (Medicaid) office.
Early October CMS Change in Extra Help Co-payment Letter (Pub. No. 11199) (ORANGE Letter) Informs people that they will continue to automatically qualify for extra help in 2009, but their co-payment levels will change as of January 1, 2009. • Keep the notice.
• No action, unless you believe an error has occurred.
October Plans Plan Marketing Materials On October 1, plans begin sending marketing materials for 2009. No action. Use this information to compare options for 2009.
October Plans Plan Termination Letter By October 2, people whose 2008 plan terminates in 2009 will get notices from plans.< You must look for a new plan for coverage in 2009.
October Plans Plan Annual Notice of Change (ANOC) Model ANOC By October 31, people will get a notice from their current plan outlining 2009 formulary, benefit design, and/or premium changes. Review changes to decide whether the plan will continue to meet your prescription drug needs in 2009.
October Plans Plan LIS Rider By October 31, all people who qualify for the LIS will get an LIS rider from their plan telling them how much subsidy they will get in 2009 towards their Part D premium, deductible, and copayments. Keep this with your plan’s Evidence of Coverage (EOC), so you can refer to it if you have questions about your costs.
October CMS Medicare & You 2009 Handbook (This is a link to the 2008 Handbook) Mailed to all Medicare households each fall and includes a summary of Medicare benefits, rights, and protections; lists of health and drug plans available in the area; and answers to frequently asked questions about Medicare. Keep the handbook as a reference guide. "Medicare & You" can also be found at www.medicare.gov.
October Employer/ Union Plans Notice of Creditable Coverage Employer/union and other group health plans must tell all Medicare-eligible plan participants whether or not their drug coverage is creditable before November 15 each year. Keep the notice.
Late October / Early November CMS LIS Choosers Letter(Pub. No. 11267) (TAN Letter) Informs LIS beneficiaries who chose a plan on their own that their plan’s premium is rising above the regional LIS premium subsidy amount, and they will be responsible for paying a portion of their plan’s premium unless they join a new plan. • Keep the notice
• You may want to look for a new plan for coverage for 2009 with a premium below the regional low income subsidy benchmark. (Letter includes list of local plans with no premium liability.)
• Change plans in early Dec. if you choose
Late October / Early November CMS Reassignment Letter (Pub. No. 11208 — Version 1) (BLUE Letter) Informs people that their current plan is leaving the Medicare Program and they will be reassigned to a new plan effective January 1, 2009, unless they join a new plan on their own by December 31, 2008. • Keep the notice.
• Compare the 2009 plans to see which plan meets your needs.
• Change plans, if you choose, in early December.• For more information call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048; check Medicare & You 2009; visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Late October / Early November CMS Reassignment Letter (Pub. No. 11209 — Version 2) (BLUE Letter) Informs auto-enrollees that because their plan’s premiums are increasing above the regional LIS premium subsidy amount, they will be reassigned to a new plan effective January 1, 2009, unless they join a new plan on their own by December 31, 2008. • Keep the notice.
• Compare the 2009 plans to see which plan meets your needs.
• Change plans, if you choose, in early December.• For more information call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048; check Medicare & You 2009; visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
November Social Security Social Security Part B Income-Related Premium Adjustment Notice Tells higher-income consumers about income-related Part B premium adjustments. Includes the information in the December BRI notices (see below). Keep the notice.
November Social Security Social Security LIS Redetermination Decision Letter Begins Social Security begins mailing decision letters about LIS eligibility for the coming year. • Keep the notice
• If you believe the decision is incorrect, you have the right to appeal it. The letter explains how to appeal.
• If you have questions, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Late November Social Security Social Security LIS and MSP Outreach Letter (Form SSA-L441) Informs people who may be eligible for QDWI about the Medicare Savings Programs and the extra help available for Medicare prescription drug plan costs. • If you think you qualify for extra help, you should apply.
• For more information about the extra help or if you want to apply, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
December Social Security Social Security Benefit Rate Increase (BRI) Notice Tells people about benefit payment changes for the coming year due to cost of living increases, variations in the premiums that are withheld, etc. Keep the notice.
Daily - ongoing CMS Deemed Status Letter (Pub No. 11166) (PURPLE Letter beginning in Sept/Oct) Informs people that they will automatically get extra help, including people 1) with Medicare and Medicaid, 2) in Medicare Savings Program, and 3) who receive Supplemental Security Income (SSI) benefits. • Keep the notice.
• No need to apply to get the extra help.
• Compare Medicare prescription drug plans with others to meet your needs.
• For more information call 1-800-MEDICARE; check Medicare & You 2009; visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Daily - ongoing CMS Auto-Enrollment Notice (Pub No. 11154) (YELLOW Letter) Informs people who qualify for Medicare & Medicaid and who currently get their benefits through the Original Medicare Plan that they will be automatically enrolled in a drug plan if they don’t enroll themselves or decline coverage. • Keep the notice.
• No need to apply to get the extra help.
• If you don’t join a plan, Medicare will enroll you in one.
• Compare Medicare prescription drug plans with others to meet your needs.
• For more information call 1-800-MEDICARE; check Medicare & You 2009; visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Daily - ongoing CMS Facilitated Enrollment Notice (Pub No. 11186 & Pub No 11191) (GREEN Letter) Informs people who either 1) belong to a Medicare Savings Program or 2) receive Supplemental Security Income (SSI), or 3) applied and qualified for the extra help that they will be automatically enrolled in a drug plan if they don’t enroll themselves or decline coverage. • Keep the notice.
• If you don’t join a plan, Medicare will enroll you in one.
• Compare Medicare prescription drug plans with others to meet your needs.
• For more information call 1-800-MEDICARE; check Medicare & You 2009; visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.

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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.