Auto-Enrollment Retroactive Notice

What is it?

If you get this YELLOW notice it means you automatically qualify for 

Extra Help

 with a retroactive (in the past) effective date because of one of the following:

You'll be automatically enrolled in a Medicare Prescription Drug Plan unless you decline coverage or join a plan yourself.

When should I get it?

You may get this notice at any time.

Who sends it?


What should I do if I get this notice?

Download a sample

"Auto-Enrollment Retroactive Notice [PDF, 671 KB]"

Get this notice in Spanish [PDF, 577 KB].

Publication, product, or other number

Product No. 11429

Unofficial name

YELLOW notice