Help with costs

People with limited income and resources may qualify for help paying their Medicare premiums, deductibles, coinsurance, copayments and prescription drug costs. If you qualify for help with your Medicare costs, you may get one or more of the mailings below from Medicare, Social Security, or your health or drug plan.

Qualifying for help with costs

  • What’s the notice called?
    Social Security LIS & MSP Outreach Notice (May)
  • Why did I get it?
    Social Security determined that you may qualify for:
    • A Medicare Savings Program to help with your Medicare premiums and other costs
    • Extra Help to help pay for your Medicare drug coverage
  • When do I get it?
    Mid-May
  • What’s the notice called?
    Social Security LIS & MSP Outreach Notice (November)
  • Why did I get it?
    Social Security determined that you might qualify for:
    • A Medicare Savings Program to help with your Medicare premiums and other costs
    • Extra Help to help pay for your Medicare drug coverage 
  • When do I get it?
    Late November


Extra Help – Automatically qualify

  • What’s the notice called?
    Deemed Status Notice
  • Why did I get it?
    You automatically qualify for Extra Help paying for your Medicare drug coverage because at least one of these conditions applies:
    • You have both Medicare and Medicaid
    • You’re in a Medicare Savings Program
    • You get Supplemental Security Income (SSI) benefits

You can join a Medicare drug plan in your area, or we'll enroll you in a plan to make sure you get Medicare drug coverage and Extra Help. You can also choose to decline this coverage.​​

   

  • When do I get it?
    Any time


Extra Help – Automatically qualify (without auto-enrollment in a drug plan)

  • What’s the notice called?
    Retiree Drug Subsidy Notice - Dual Eligibles
  • Why did I get it?
    You qualify for Extra Help paying for Medicare drug coverage because you qualify for Medicaid in all or part of this year. However, we won’t automatically enroll you in a Medicare drug plan because you already have other prescription drug coverage.
  • When do I get it?
    Any time


Extra Help - Reminder to join a drug plan

  • What’s the notice called?
    Facilitated Enrollment Notice: Full Subsidy or Partial Subsidy
  • Why did I get it?
    You have Original Medicare and qualify for Extra Help paying for Medicare drug coverage. You can select and join a Medicare drug plan, or we’ll automatically enroll you in a plan. You can also choose to decline this coverage.
  • When do I get it?
    Any time


Extra Help - Loss of eligibility

  • What’s it called?
    Loss of Deemed Status Notice
  • Why did I get it?
    Social Security determined that you no longer automatically qualify for Extra Help with your Medicare drug coverage next year. You may still qualify for help paying your Medicare drug coverage in the upcoming year, but you’ll have to apply through Social Security to find out.
  • When do I get it?
    September


Extra Help - Auto-enrollment (with a future coverage start date)

  • What’s the notice called?
    Auto-Enrollment Notice
  • Why did I get it?
    You automatically qualify for Extra Help paying for your Medicare drug coverage. We’ll be enrolling you in a Medicare drug plan soon, unless you decline coverage or choose a different plan.
  • When do I get it?
    Any time


Extra Help - Auto-enrollment (with a coverage start date in the past)

  • What’s the notice called?
    Auto-Enrollment Retroactive Notice
  • Why did I get it?
    You automatically qualify for Extra Help paying for your Medicare drug coverage in the upcoming year. Also, you may be able to get back some of the cost of certain prescriptions you filled in the past. We’re enrolling you in a Medicare drug plan soon, unless you decline coverage or choose a different plan. 
  • When do I get it?
    Any time


Extra Help - Eligibility review

  • What’s the notice called?
    Social Security Review Eligibility for Extra Help Notice
  • Why did I get it?
    Social Security needs to find out if you still qualify for Extra Help paying for your Medicare drug coverage. You must fill out and return the “Income and Resources Summary” sheet that comes with the notice.
  • When do I get it?
    November


Extra Help - Annual eligibility decision

  • What’s the notice called?
    Social Security LIS Redetermination Decision Notice
  • Why did I get it?
    To tell you if you’ll still qualify for Extra Help paying for your Medicare drug coverage in the upcoming year.
  • When do I get it?
    Early September

Costs & coverage when you’re getting Extra Help

Your Extra Help amount

  • What’s the notice called?
    Plan LIS Rider
  • Why did I get it?
    Your plan tells you how much Extra Help you’ll get next year to pay your Medicare drug plan premium, deductible, and copayments.
  • When do I get it?
    September


Your copayment is changing  

  • What’s the notice called?
    Change Extra Help Copayment Notice
  • Why did I get it?
    You’ll continue to automatically qualify for Extra Help paying for your Medicare drug coverage in the upcoming year, but your prescription copayment amount is changing.
  • When do I get it?
    October


Your plan’s premium is changing

  • What’s the notice called?
    LIS Choosers Notice
  • Why did I get it?
    You get Extra Help paying for your Medicare drug coverage, you joined a Medicare drug plan on your own, and your plan's premium is changing. You'll have to pay a portion of your plan's premium in the upcoming year unless you join a new $0 premium plan.
  • When do I get it?
    Early November


Your drug plan is changing (due to plan leaving Medicare)

  • What’s the notice called?
    Reassignment Notice - Plan Termination
  • Why did I get it?
    You get Extra Help paying for your Medicare drug coverage, and your current drug plan is leaving the Medicare program. We’ll automatically enroll you in a new Medicare drug plan for the upcoming year, or you can choose a plan.
  • When do I get it?
    Late October


Your drug plan is changing (due to premium increase)

  • What’s the notice called?
    Reassignment Notice - Premium Increase
  • Why did I get it?
    You get Extra Help paying for your Medicare drug coverage, and your current drug plan’s premium for next year is higher than the amount that Extra Help covers. We’ll automatically enroll you in a new Medicare drug plan for the upcoming year, unless you choose to stay in your current plan or switch to a different plan.
  • When do I get it?
    Late October


Your drug plan is changing (due to Medicare Advantage Plan leaving Medicare)

  • What’s the notice called?
    Medicare Advantage Plan Reassignment Notice
  • Why did I get it?
    You get Extra Help paying for your Medicare drug coverage, and your current Medicare Advantage Plan is leaving the Medicare program. We’ll automatically enroll you in a Medicare drug plan for the upcoming year if you don't join a Medicare drug plan on your own. You also have a chance to buy a Medigap policy because your plan is leaving Medicare.
  • When do I get it?
    Late October – Early November


Your drug coverage in your new Medicare drug plan

  • What’s it called?
    Reassign Formulary Notice
  • Why did I get it?
    To tell you if the new Medicare drug plan we’re enrolling you in for next year will cover the prescriptions drugs you’ve taken in the last year.
  • When do I get it?
    December