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Reminder about Fall 2023 Medicare mailings from CMS and the Social Security Administration affecting your Extra Help benefits

Category: Medicaid, LIS, & Extra Help
Published: Jul, 18 2023 10:07:17

The 2023/2024 mailings schedule from the Centers for Medicare and Medicaid Service (CMS), the Social Security Administration (SSA), and Medicare plans is online and includes the different information and form-letters sent to Medicare plan members, Medicare Part D Extra Help recipients (people qualifying for the Medicare Part D Low-Income Subsidy (LIS) program), and people who are assessed Medicare Part B and Medicare Part D income-related monthly adjustment amounts (IRMAA).

The color-coded mailings list can be found online here: Q1Medicare.com/LISMailings and is updated with additional information and links to our Frequently Asked Questions (FAQs) and News Articles.

Important: Some Medicare Part D beneficiaries will need to act in order to keep their Extra Help benefits.

As a reminder, if you are a Medicare Part D beneficiary receiving financial "Extra Help" with your Medicare prescription drug plan, you may need to submit information about your financial situation in order to continue receiving your Medicare Part D financial Extra Help benefits through 2024.

Starting in early-September 2023, SSA and CMS will be sending letters to some Medicare beneficiaries regarding the status of their Medicare Part D Extra Help benefits.  If you are a Medicare beneficiary who receives one of these letters and does not respond to this September mailing, you risk losing your Extra Help benefits for next year.

If you currently qualify for the Medicare Part D financial Extra Help program, there are two possible letters you could receive in September that could affect whether you receive Medicare Part D Extra Help next year:

   (1)  Letter from the Social Security Administration (SSA): You need to show that you still qualify for Extra Help!

Each year the Social Security Administration (SSA) reviews the eligibility of selected low-income Medicare beneficiaries who are receiving financial Extra Help and in early-September, will send letters to select Medicare beneficiaries who qualified for the Extra Help program this year and ask that the recipient completes and returns a new income and resources form to ensure that the beneficiary is still eligible for the Extra Help program.

Look for the title: "Social Security Notice to Review Eligibility for Extra Help" along with income and asset forms - you will need to complete and return these forms to the SSA to keep your Extra Help.

Unfortunately, if a person does not complete and return the income and resources form to the Social Security Administration within 30 days, or ask for an extension, the beneficiary could lose their Extra Help benefits for next year.  If you have questions, please call Social Security at 1-800-772-1213 (TTY users can call 1-800-325-0778).

   (2)  Grey Letter from the Centers for Medicare and Medicaid Services (CMS): You no longer automatically qualifying for Extra Help!

Some people receive Medicare Part D Extra Help automatically because they qualify for both Medicare and Medicaid - or belong to a Medicare Savings Program (MSP) - or receive Supplemental Security Income (SSI).

However, if a person no longer automatically qualifies for Extra Help (because of a change in their financial or SSI status), CMS will send a gray-colored “Loss of Deemed Status” letter before the end of September notifying the Medicare beneficiary that they may need to reapply for their Extra Help benefits for next year.

Again, look for a gray-colored Notice that states across the top: Loss of Deemed Status Notice (Product No. 11198) and you will see the text: "Your automatic Extra Help for Part D will end in 2023" and then the following text:
MPORTANT: Apply now to see if you can still get Extra Help
You may still be able to get Extra Help in 2024, but you need to apply. How to apply:
  • Complete the enclosed application and mail it back in the postage-paid envelope.
  • Or, apply online at SSA.gov.
  • Or, call Social Security at 1-800-772-1213 to apply by phone. TTY users can call
Apply as soon as possible to make sure you get Extra Help in 2024, if you qualify.
To help people keep their Extra Help benefits, CMS will also include an application for Extra Help along with their grey-colored letter and encourage Medicare beneficiaries to complete the application for the 2024 Extra Help program based on their income and resource limits.

Bottom Line:  Unfortunately, if these Medicare beneficiaries do not proactively complete the application and reapply for Extra Help, they may lose their Extra Help benefits in 2024.

Question:  What is Medicare Part D Extra Help?

For those new to Medicare, "Extra Help" is a federal program designed to assist low-income Medicare beneficiaries pay a portion of their Medicare prescription drug costs.  Based on your income and assets (or financial resources), the Extra Help program may pay all or part of your monthly Medicare Part D plan premiums and a significant portion of your medication costs.  Also, if you qualify for Extra Help, you pay either a low or no initial deductible and will not be subject to the Coverage Gap or Donut Hole portion of your Medicare Part D plan coverage.

We have more information online about the Extra Help drug co-payments at: 2023 Federal Poverty Level Guidelines (FPL): 2023/2024 LIS Qualifications and Benefits.

As an Extra Help recipient, you will also be granted a Special Enrollment Period (SEP) (one SEP per quarter from January through September) during which you can change to another Medicare Part D prescription drug plan.

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).

Reminder - Part 1:  You may still qualify for Extra Help in 2023.

As a reminder the Medicare Part D Extra Help income and basic resource limits increased slightly this year, making it easier for some people to qualify for the Extra Help program and receive financial assistance with the purchase of their prescription drugs.  To help people learn about the Extra Help program and qualifying for Extra Help, we have added more information online about the recently updated income and resource limit changes that can be found at:
Medicaid and Medicare Part D Prescription Drug Plan Costs

Reminder - Part 2:  Be prepared to see how your Medicare Part D or Medicare Advantage plan is changing in 2024.

All Medicare Part D beneficiaries are reminded that their Medicare Part D prescription drug plan or Medicare Advantage plan can change monthly premiums, co-payments, and specific drug coverage (formularies) each year.  Therefore, all Medicare Part D beneficiaries should be prepared to review their 2024 Medicare Part D plan options and, if necessary, change their plan during the 2024 annual Open Enrollment Period (AEP) that begins on October 15th and continues through December 7th.

You can also review your Medicare Part D plan options using our Part D Plan Finder: PDP-Finder.com and or Medicare Advantage Plan Finder: MA-Finder.com.

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