Guide to CMS, SSA and Medicare Plan Mailings for Beneficiaries this Fall

Guide to CMS, SSA and Medicare Plan Mailings for Beneficiaries this Fall

The Center for Medicare and Medicaid Services (CMS) recently published a chart outlining the various letters and notices beneficiaries, particularly those with low-incomes, will be receiving this fall from CMS, Social Security and Medicare Advantage and Part D plans. The chart describes:

  • when and to whom each notice will be sent,
  • who is sending the notice;
  • what the notice says, and
  • what, if any, action the beneficiary must take upon receiving the notice.

Specific numbers of California beneficiaries (and beneficiaries in other states) to receive these notices will be posted on CMS’ website closer to each notice’s ‘send date’ at cms.hhs.gov/LimitedIncomeandResources.

Some key notices and dates on the chart include:

September:

Loss of Deemed Status Letter (Pub. No. 11198) (GREY Letter) – tells people that they no longer automatically qualify for extra help as of January 1, 2009. It also advises people to apply for extra help through Social Security (application and postage paid envelope enclosed) or a State Medical Assistance (Medicaid) office.

October:

Change in Extra Help Co-payment Letter (Pub. No. 11199) (ORANGE Letter) – Informs people that they will continue to automatically qualify for extra help in 2009, but their co-payment levels will change as of January 1, 2009.

Medicare Advantage and Part D plans will begin sending out marketing materials about their plans starting October 1st. They will also send out their plan termination notices by October 2nd if any of their plans are terminating their contracts with Medicare.

Plan Annual Notice of Change (ANOC)sent by October 31stto plan enrollees, this notice outlines any 2009 plan changes in formularies, benefit designs and/or premiums.

LIS riderBy October 31, all people who qualify for the Part D low-income subsidy (LIS) will get an LIS rider from their plan telling them how much subsidy they will get in 2009 towards their Part D premium, deductible, and copayments. Beneficiaries can keep this notice on file with their plan’s Evidence of Coverage information.

Medicare & You 2009 Handbook – these booklets will be mailed to all Medicare households and include a summary of Medicare benefits, rights, and protections; lists of health and drug plans available in the area; and answers to frequently asked questions about Medicare.

Notice of Creditable CoverageEmployer/union and other group health plans must tell all Medicare-eligible plan participants whether or not their drug coverage is creditable before November 15 each year.

Late October/Early November:

LIS Choosers Letter (Pub. No. 11267) (TAN Letter) CMS reversed their earlier decision not to send this letter and is now going to send it to LIS beneficiaries who chose a plan on their own for 2008 and whose plan’s premium will be rising above the regional LIS premium subsidy amount for 2009. The letter informs them that they will be responsible for paying a portion of their plan’s premium unless they join a new plan with a premium at or below the 2009 LIS premium subsidy amount (also referred to as the ‘benchmark’ amount).

Reassignment Letters – CMS will send out 2 of these:

  • Pub. No. 11208 – Version 1 (BLUE Letter) – Informs people that their current plan is leaving the Medicare Program and they will be reassigned to a new plan effective January 1, 2009, unless they join a new plan on their own by December 31, 2008.
  • Pub. No. 11209 – Version 2 (BLUE Letter) – Informs beneficiaries who were auto-enrolled into their current plan that because their plan’s premiums are increasing above the regional LIS premium subsidy amount, they will be reassigned to a new plan effective January 1, 2009, unless they join a new plan on their own by December 31, 2008.This letter differs from the LIS Choosers letter in that these beneficiaries will be auto-enrolled into a new plan with a benchmark premium if they take no action themselves, whereas the ‘LIS Choosers’ will remain in their current plan and be responsible for the additional costs if they take no action.

Available online, the chart may well be a handy autumn office decoration.

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.