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Reminder about September Medicare mailings from CMS and the Social Security Administration affecting your 2019 Extra Help benefits


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Reminder about September Medicare mailings from CMS and the Social Security Administration affecting your 2019 Extra Help benefits
Published on 2018-09-21 17:38:34
Category: Medicaid, LIS, & Extra Help


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.


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