MEDICARE D EXTRA HELP ELIGIBILITY REVIEW BEGAN IN AUGUST

Those who get extra help with Medicare D costs, may be contacted by Social Security to review eligibility for the upcoming year. This review will ensure that beneficiaries getting the extra help are still eligible and receiving all the benefits they deserve. Members are also required to report changes in status. In that case, the review process will differ and the member will receive a notice to explain the process.

When will Social Security do this review?

Under the law, the reviews must begin within the first 12 months of eligibility.

• Those who became eligible between January and April 2006, or applied in 2005 and became eligible in January 2006, may be reviewed as early as August 2006.
• Those who became eligible in May 2006, or later, will be reviewed no earlier than August 2007.

How will Social Security contact members?

Social Security will contact members by mail. The letter will include what Social Security records show. If this information is correct, the member should do nothing. I f it has changed, the member should return a one-page letter, enclosed with the mailing, to Social Security within 15 days.

Important Note: A cost of living increase in one’s Social Security benefit will not be considered a change in situation. Members should not return the letter only to report a cost of living increase in Social Security benefit.

What happens if a member’s situation has changed?

Members should return the letter indicating a change in situation. Social Security will then send a form called, “ Social Security Administration Review of Your Eligibility for Extra Help”. Members have 30 days to complete and return this form. If completed within the 30-day period, any necessary adjustments to the extra help will be effective in January of the following year, as long as one’s marital status is the same. For example, if a letter is sent in August 2006 and the review form showing a change is returned, any adjustment would be effective January 2007.

When my situation is reviewed, what will happen to my extra help?

Any of the following could occur:

• No change in the amount of extra help;
• An increase in the amount of extra help;
• A decrease in the amount of extra help; or
• Termination of extra help.

Social Security will send a letter explaining the decision reached. Members have the right to appeal. The letter will explain the appeal rights. 

How can I get more information?

For information about the Medicare Prescription Drug Plan or other Medicare issues, visit www.medicare.gov or call toll-free 1-800-MEDICARE ( 1-800-633-4227); (TTY 1-877-486-2048).

For information about Medicare D Extra Help or general information about Social Security, visit www.socialsecurity.gov. You also can call Social Security toll-free at 1-800-772-1213; (TTY 1-800-325-0778).

If you do call, please have the letter handy.

-Adapted from “Review of Your Eligibility For Extra Help With Medicare Prescription Drug Plan Costs Begins August 2006: Some Things You Should Know”, SSA Publication No. 05-10111, August 2006, ICN 444780 http://www.socialsecurity.gov/pubs/10111.html

11/06