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 act soon in order to continue receiving your Medicare Part D financial Extra Help benefits through 2013.
Starting in early-September, the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) will be sending out 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 2013.
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. We have more information online about the Extra Help drug co-payments at on this site.
Also, if you qualify for Extra Help, you will also pay either a low or no initial deductible and will not be subject to the Coverage Gap or Doughnut Hole portion of their Medicare Part D plan. As an Extra Help recipient, you will also be granted a continuous Special Enrollment Period (or SEP) during which you can change to another Medicare Part D prescription drug plan at any time throughout the year.
As noted, if you qualify for the 2012 Extra Help program, there are two possible letters you could receive in the mail that could affect whether you receive Extra Help in 2013:
(1) Letter from the Centers for Medicare and Medicaid Services (or CMS): You No Longer Automatically Qualifying for Extra Help!
Some people receive Medicare Part D Extra Help automatically because they qualify for Medicaid - or belong to a Medicare Savings Program - or receive Supplemental Security Income (SSI). However, if a person no longer automatically qualifies for Extra Help in 2013 (because of a change in their financial or SSI status), CMS will send a grey-colored “Loss of Deemed Status” letter before the end of September notifying the Medicare beneficiary that they may need to reapply for their 2013 Extra Help benefits.
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 2013 Extra Help program based on their income and resource limits.
Unfortunately, if these Medicare beneficiaries do not proactively complete the application and reapply for Extra Help, they may lose their Extra Help benefits in 2013.
(2) Letter from the Social Security Administration (or SSA): You Need to Show that You Still Qualify for Extra Help!
Each year the Social Security Administration 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 2012 Extra Help program and ask that the recipient completes and returns a new income and resources form to ensure that the beneficiary is still eligible for the 2013 Extra Help program.
Unfortunately, again, 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 2013.
Reminder: You may still qualify for Extra Help in 2012.
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 on this site.
Reminder #2: Be prepared to see how your Medicare Part D or Medicare Advantage plan is changing in 2013.
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 each year. Therefore, all Medicare Part D beneficiaries should be prepared to review their 2013 Medicare Part D plan options and, if necessary, change their plan during the 2013 annual Open Enrollment Period that begins on Monday, October 15, 2012 and continues through Friday, December 7, 2012.
The details of the 2013 Medicare Part D and Medicare Advantage plans should be available in late-September or early-October and on this site now offers a free 2013 eMail reminder service to keep Medicare beneficiaries informed as the 2013 Medicare plan information becomes available. The reminder services can found directly at on this site.