The Social Security Administration (SSA) has begun mailing "SSA Medicare Prescription Drug Assistance Notice of Termination" letters to some beneficiaries who are currently receiving the low-income subsidy (LIS) or "Extra Help."  The letters are being sent to beneficiaries who did not provide SSA with information it requested to determine their continuing eligibility for the LIS. 

About 76,000 beneficiaries began receiving this mailing during the week of March 2. Beneficiaries who do not act immediately upon receiving the letter to request an appeal will no longer receive the LIS to pay for Part D premiums and cost-sharing effective April 1.

SSA requested information in September 2007 as part of its formal redetermination process.  The process, which was completed in February, involved multiple attempts by SSA to contact beneficiaries who were subject to redetermination.  SSA indicates that approximately 80,000 people responded to its follow-up contacts; people who responded should not receive the SSA "Medicare Prescription Drug Assistance Notice of Termination" letter being sent out this week.

Beneficiaries who believe they are, or even might still be, eligible for the LIS should contact SSA within 10 days of receiving their letter to request an appeal.  If they do so, they can continue receiving LIS until their appeal has been decided, regardless of whether it is decided in their favor.  

Appeals can be filed after the 10 days but not later than 60 days after receiving the SSA letter, but beneficiaries filing after the first 10 days will not continue to receive LIS pending their appeal.  LIS may also continue for beneficiaries who can show good cause why they did not file an appeal within 10 days

Call SSA at 1-800-SSA-1213 (1-800-772-1213) to file an appeal.

In addition to taking action to file an appeal, beneficiaries should know:

1. They can reapply for LIS, even if they are not currently eligible, if their circumstances change, making them eligible once again.  Beneficiaries who do not appeal must wait until April 1 to reapply. Otherwise, the applications will be considered duplicates and will not be processed by SSA. Applications can be made by calling SSA at the above number or by filing on-line at http://www.ssa.gov/prescriptionhelp/

 

2. Their current drug plan will contact them to let them know how much their premium will be, starting April 1, without the LIS

 

3. They will have a 3-month special enrollment period, starting April 1, to enroll in a different drug plan, if they choose not to remain in the one in which they are currently enrolled.

For assistance with your appeal or with an application, check www.shiptalk.org for information about a local health insurance counseling program near you.

The Center for Medicare Advocacy may have more details on the Notice of termination letters after 03/07/08.  For more information, please contact attorney Patricia Nemore in the Center's Washington, DC office at (202) 293-5760

or pnemore @ medicareadvocacy.org (remove spaces).