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Guide to LIS Mailings from CMS, Social Security and Plans in 2017/2018

SUMMER / FALL 2017 THROUGH 2018


Mail Date Sender Mailing/Color Main Message Consumer Action
Mid-May Social Security Social Security LIS and MSP Outreach Notice (SSA Pub. Forms L447 & L448) Informs people who may be eligible for Medicare Savings Programs (MSPs) about MSPs and the Extra Help available for Medicare prescription drug coverage. • If you think you qualify for Extra Help, you should apply.
• Apply for Extra Help through Social Security.
Early September Social Security Social Security Notice 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. Includes an "Income and Resources Summary" sheet. If you get this notice, you must return the enclosed form in the enclosed postage-paid envelope within 30 days or your Extra Help may end.
September Plans Plan Annual Notice of Change (ANOC) and Evidence of Coverage (EOC)
Model ANOC
By September 30, people will get a notice from their current plan outlining 2018 formulary, benefit design, and/or premium changes. Review changes to decide whether the plan will continue to meet your needs in 2018.
September Plans Plan LIS Rider Model LIS Rider By September 30, all people who qualify for Extra Help will get an LIS rider from their plan telling them how much help they’ll get in 2018 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.
September CMS Loss of Deemed Status Notice (Product No. 11198) (GRAY Notice) Informs people that they no longer automatically qualify for Extra Help as of January 1, 2018. Apply for Extra Help through Social Security (application and postage-paid envelope enclosed) or a State Medical Assistance (Medicaid) office.
Late September CMS "Medicare & You" Handbook Mailed to all Medicare households each fall. Includes a summary of Medicare benefits, rights, and protections; lists of available health and drug plans; and answers to frequently asked questions about Medicare. Keep the handbook as a reference guide. You can also download a copy online at medicare.gov.
Early October Employer/ union plans Notice of Creditable Coverage By October 15, employer/union and other group health plans must tell all Medicare-eligible enrollees whether or not their drug coverage is creditable. Keep the notice.
October Plans Plan Marketing Materials On October 1, plans begin sending marketing materials for 2018. Use this information to compare options for 2018.
October Plans Plan Non-Renewal Notice By October 2, people whose 2017 plan is leaving the Medicare program in 2018 will get notices from plans. You must look for a new plan for coverage in 2018.
October CMS Change in Extra Help Co-payment Notice (Product No. 11199) (ORANGE Notice) Informs people that they still automatically qualify for Extra Help, but their copayment levels will change starting January 1, 2018. • Keep the notice.
• No action, unless you believe an error has occurred.
Late October CMS Consistent Poor Performer Notice (Product No. 11627) Informs people that they’re enrolled in a plan that has been identified as a consistent poor performer (i.e. fewer than 3 stars for 3 or more consecutive years) and encourages them to explore other plan options in their area. • Visit Medicare.gov/find-a-plan find and compare plans in your area.
• You can change plans during the Open Enrollment Period (October 15–December 7). Call 1-800-MEDICARE (1-800-633-4227) to change plans outside of this period. TTY users should call 1-877-486-2048.
Late October CMS Reassignment Notice - Plan Termination (Product No. 11208) (BLUE Notice) Informs people that their current Medicare drug plan is leaving the Medicare Program and they’ll be reassigned to a new Medicare drug plan effective January 1, 2018, unless they join a new plan on their own by December 31, 2017. • Keep the notice.
• Compare 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," visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Late October CMS Reassignment Notice - Premium Increase (Product No. 11209) (BLUE Notice) Informs auto-enrollees that because their current Medicare drug plan premium is increasing above the regional LIS premium subsidy amount, they’ll be reassigned to a new Medicare drug plan effective January 1, 2018, unless they join a new plan on their own by December 31, 2017. LIS Qualifications & Benchmark Blogs • Keep the notice.
• Compare 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," visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Late October / Early November CMS MA Reassignment Notice (Product No. 11443) (BLUE Notice) Informs people who get Extra Help and whose current Medicare Advantage (MA) plan is leaving the Medicare Program that they’ll be re-assigned to a Medicare drug plan effective January 1, 2018, if they don’t join a new MA or PDP plan on their own by December 31, 2017. • Keep the notice.
• Compare plans to see which plan meets your needs.
• Change plans, if you choose, in early December.
• For more information, call 1-800-MEDICARE, check "Medicare & You," visit www.medicare.gov, or contact the SHIP for free personalized help.
Early November CMS LIS Choosers Notice (Product No. 11267) (TAN Notice) Informs people who get Extra Help and chose a Medicare dug plan on their own that their plan’s premium is changing, and they’ll have to pay a portion of their plan’s premium in 2018 unless they join a new $0 premium plan. • Keep the notice.
• You may want to look for a new plan for coverage for 2018 with a premium below the regional low income subsidy benchmark. (Notice includes list of local plans with no premium liability.)
• Change plans in early December if you choose. LIS Qualifications & Benchmark Blogs
November CMS CMS Non-Renewal Reminder Notice (Product No. 11433 & 11438) Reminds people who don’t get Extra Help and whose plan is leaving the Medicare Program that they need to choose a new plan for 2018. You must look for a new plan for coverage in 2018.
November Social Security Social Security Part B & Part D Income-Related Premium Adjustment Notice (IRMAA) Tells higher-income consumers about income-related Part B and Part D premium adjustments. Includes the information in the December BRI notices (see below). Keep the notice.
Learn more:
IRMAA: Higher Incomes and Costs FAQs and IRMAA - for Higher Incomes News
November Social Security Social Security LIS Redetermination Decision Notice Begins Social Security begins mailing notices letting people know whether they still qualify for Extra Help in the coming year. • Keep the notice
• If you believe the decision is incorrect, you have the right to appeal it. The notice explains how to appeal or see Appealing SSA’s "Extra Help" Decision
• 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 Notice (Form SSA-L441) Informs people who may be eligible for Qualified Disabled Working Individual (QDWI) about the Medicare Savings Programs and the Extra Help available for Medicare prescription drug coverage. • 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 Change (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.
December CMS Reassign Formulary Notice (Product No. Product No. 11475 & 11496) (BLUE Notice) Informs people who get Extra Help and were affected by reassignment which of the Part D drugs they took in 2017 will be covered in their new 2018 Medicare drug plan. • Consider whether this plan is right for you, or whether another plan might cover more of your drugs.
• Compare this Medicare drug plan with others in your area.
• For more information call 1-800-MEDICARE (1-800-633-4227), check "Medicare & You," visit Medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help. TTY users should call 1-877-486-2048;
December - January CMS Qualifying Health Coverage Initial Cover Notice (Product No. Product No. 11865) This notice accompanies IRS Form 1095-B (Health Coverage). It informs people with Medicare Part A (Hospital Coverage) that their coverage is considered qualifying health coverage, which is required by the Affordable Care Act. Keep this form 1095-B with your important tax information.
January CMS CMS Non-Renewal Action Notice (Product No. 11452) Reminds people who don’t get Extra Help and whose Medicare plan left the Medicare Program that they need to join a new Medicare drug plan if they want Medicare drug coverage for 2018. You must join a Medicare drug plan by February 28 if you want Medicare drug coverage for 2018.
Daily - ongoing CMS Deemed Status Notice (Product No. 11166) (PURPLE Notice beginning in Sept/Oct) Informs people that they’ll automatically get Extra Help, including people
1) Wth Medicare and Medicaid,
2) Belong to Medicare Savings Program, and
3) Who get 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 (1-800-633-4227), check "Medicare & You", visit Medicare.gov, or contact the SHIP for free, personalized help.
Daily - ongoing CMS Auto-Enrollment Notice (Product No. 11154) (YELLOW Notice) Sent to people who automatically qualify for Extra Help because they qualify for Medicare and Medicaid and currently get their benefits through Original Medicare. These people will be automatically enrolled in a drug plan unless they decline coverage or enroll in a plan themselves. • 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 (1-800-633-4227), check "Medicare & You", visit Medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help. TTY users should call 1-877-486-2048;
Daily - ongoing CMS Auto-Enrollment Retroactive Notice (Product No. 11429) (YELLOW Notice) Sent to people who automatically qualify for Extra Help with a retroactive effective date because they either
1) qualify for Medicare & Medicaid or
2) get Supplemental Security Income (SSI).

These people will be automatically enrolled in a drug plan unless they decline coverage or enroll in a plan themselves.
• 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 (1-800-633-4227), check "Medicare & You", visit Medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Daily - ongoing CMS Facilitated Enrollment Notice (Product No. 11186 & Product No. 11191) (GREEN Notice) Informs people that they’ll be automatically enrolled in a drug plan unless they decline coverage or enroll in a plan themselves, including people who:
1) Belong to a Medicare Savings Program,
2) Get Supplemental Security Income (SSI),
3) Applied and qualified for Extra Help
• 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 (1-800-633-4227), check "Medicare & You", visit www.medicare.gov, or contact the State Health Insurance Assistance Program (SHIP) for free personalized help.
Daily - ongoing CMS Full-Benefit Dual Eligible (FBDE) Retiree Drug Subsidy (RDS) Notice (Product No. 11334) Informs people with Medicare & Medicaid who already have qualifying creditable drug coverage through an employer or union that they automatically qualify for Extra Help, and can join a Medicare drug plan if they want to at no cost to them. Contact your employer or union plan to learn how joining a Medicare drug plan may affect your current coverage.
Daily - ongoing Social Security Initial IRMAA Determination Notice Sent to people with Medicare Part B and/or Part D when Social Security determines whether any IRMAA amounts apply. Notice includes information about Social Security’s determination and appeal rights. Keep this notice


Also see:

If you receive the full Extra-Help, full LIS, or are dual eligible for Medicare and Medicaid, there are Medicare Prescription Drug plans in your state the will qualify for the $0 monthly premium. Click on your state below to see PDP plans that qualify for the $0 premium:
AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  PR  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY 


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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.