The
2018 / 2019 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 form-letters sent to Medicare Part D Extra Help recipients and people qualifying for the Medicare Part D Low-Income Subsidy (LIS) program.
We have updated the list with a few links to our
Frequently Asked Questions (FAQs) and
News Articles:
Q1Medicare.com/PartD-CMS-LIS-AnnualNoticesAndMailings.php
Important: You may need to act to keep your 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 act soon in order to continue
receiving your Medicare Part D financial Extra Help benefits through 2019.
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 2019. If you qualify for the
2018 Extra Help program, there are two possible
letters you could receive in the mail that could affect whether you
receive Extra Help in 2019:
(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 2019 (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 2019 Extra
Help benefits.
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 "
You no longer automatically qualify for Extra Help"
and then the following text:
You must apply to see if you still qualify
You may still be able to get Extra Help in 2019, but you need to apply. Please complete the
enclosed application and mail it back in the postage-paid envelope. You can also apply online
at socialsecurity.gov. To apply by phone, call Social Security at 1-800-772-1213.
TTY users should call 1-800-325-0778. You can also call your State Health Insurance Assistance Program
(SHIP) at <your SHIP phone number will be here> for help.
Don’t delay. Apply as soon as possible to make sure that, if you qualify,
you’ll continue to get Extra Help as of January 1, 2019.
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
2019 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 2019.
(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 2018 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 2019 Extra Help
program.
Look for: "
Social Security Notice to Review Eligibility for Extra Help"
along with income and asset forms.
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 2019.
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. We have more information
online about the Extra Help drug co-payments at:
2018 Federal Poverty Level Guidelines (FPL): 2018-2019 LIS Qualifications and Benefits.
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 Donut Hole portion of their Medicare Part D plan.
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.
Reminder - Part 1: You may still qualify for Extra Help in 2018.
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 2019.
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 2019 Medicare Part D plan
options and, if necessary, change their plan during the 2019 annual Open Enrollment Period (AEP) that
begins on October 15 and continues through December 7.
The details of the 2019 Medicare Part D and Medicare Advantage plans should be available in late-September
or early-October and we offer our free Q1Medicare email reminder service to keep Medicare beneficiaries
informed as the 2019 Medicare plan information becomes available. The reminder services can found directly
at
Q1Medicare.com/RemindMe.