Under the Medicare prescription drug benefit, there is extra help available to beneficiaries with limited incomes and resources. This extra help provides comprehensive coverage with no or low premiums and low or no deductible. To ensure that beneficiaries receive the benefit of the extra help, CMS is facilitating the enrollment of certain beneficiaries into prescription drug plans. The week of March 20, CMS will begin mailing letters to approximately 1.2 million people who are enrolled in other federal assistance programs such as Supplemental Security Income (SSI) and Medicare Savings Programs, as well as beneficiaries who have applied for and been approved for the extra help.
The letters let the beneficiary know in which Medicare prescription drug plan they will be enrolled by CMS if they take no action before April 30. Unless they enroll on their own during March, these beneficiaries will have their prescription drug coverage begin on May 1. CMS is enrolling these beneficiaries earlier to make sure that they receive the benefit of the extra help immediately, and without having to pay a penalty. These beneficiaries can still decline the enrollment before it becomes effective.
All of the plans that qualify for the automatic enrollment must meet Medicare’s standards for access to medically necessary drugs at a convenient local pharmacy. Beneficiaries also have the option to change plans if they are unhappy with the plan into which CMS facilitated them. The letters make it clear to beneficiaries that they can choose a different approved plan in their area. The facilitated enrollment letter will list all the prescription drug plans available in their region with premiums at or below the low-income premium subsidy amount. It also recommends calling 1-800-MEDICARE to find out more about these plans.
A fact sheet with more information about facilitated enrollment is available through a link shown below. In addition, copies of the facilitated enrollment letters are also available through a link below.
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