Helping People Eligible for Extra HelpWhat You Need to Know about LIS

National Medicare Training Program

Audio-conference Training

September 26, 2007

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Today’s Topics

CMS strategies and objectives for 2008Overview of prescription drug coveragePeople with changes in 2008

AudiencesTarget messagesActions

Resources

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CMS Strategies

Annual enrollment period begins November 15 Year-round efforts to reach people with low-income Some will have changes for 2008

LIS eligibilityPlan enrollment

CMS specific focusThose potentially eligible for LISThose with LIS who face changes in 2008 premiums

July 2007 document describes our plans

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Looking at 2008

Review and select plans during the annual enrollment period

Greater number facing changes in 2008Some face increase in premium if they

remain in current plan1.5 million will be reassigned to a new plan

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CMS Objectives

Work with partners to help peopleUnderstand coverage and optionsPrepare for changes in 2008Make confident and informed decisions

Prescription Drug Coverage and Extra Help

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Prescription Drug Coverage

Coverage began January 1, 2006Available for all people with Medicare Provided through

Medicare Prescription Drug PlansMedicare Advantage Plans and other

Medicare plans

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Prescription Drug Costs

Costs vary by plan Most people will pay

Monthly premiumDeductibleCopayments or coinsuranceVery little after

• $3,850 out-of-pocket in 2007• $4,050 out-of-pocket in 2008

Extra help for people with limited income and resources

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Extra Help

Eligibility determined by SSA or stateSome groups are automatically eligible

People with Medicare and• Medicaid• Supplemental Security Income only• Medicare Savings Programs

Everyone else must apply

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How to Apply for Extra Help

Multiple ways to applySocial Security

• Paper application• www.socialsecurity.gov• 1-800-772-1213 (TTY 1-800-325-0778)

State Medical Assistance officeLocal organization

You or someone on your behalf can apply

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Costs for Those With Extra Help

Below Federal poverty level save over 95%People with lowest income and resources

Pay no premiums or deductiblesHave small or no copayments

People with slightly higher income and resourcesHave a reduced deductiblePay a little more out of pocket

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Continuing Eligibility for LIS

CMS re-establishes eligibility each fallExtra help continued or changed

Based on continued eligibility

Changes effective January 1Those automatically eligible for 2007

Continue to qualify through December 2007

People no longer eligibleAutomatic status will end December 31, 2007

Those With LIS Changes

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Those with LIS Changes

Loss of deemed statusChange in extra help copaymentSelected for review by SSA

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Deemed Status Changes

Two groups1. Those who no longer qualify automatically

2. Those who qualify for 2008 but with a change of copayment level

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1. No Longer Qualify for LIS

CMS letter in September GREY PAPERNo longer automatically qualify for LIS

• As of January 1, 2008

Application for extra help

ActionApply for extra help

• Social Security AdministrationOr

• State Medical Assistance (Medicaid) office

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2. Change in Copayment

CMS letter in early October ORANGE PAPERContinue to qualify for extra help in 2008Copayment levels change January 1, 2008

ActionKeep the noticeNo action if information is correct

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Selected for Review by SSA

Social Security letter in SeptemberForm 1026“Income and Resources Summary” sheet

ActionReturn enclosed form within 30 days or extra

help may terminate

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Reassigning to New PDP

Each fall, CMS reassigns LIS beneficiaries with 100% premium subsidy to a new PDP

• PDP is terminatingOr

• PDP premium increase • $1 over regional LIS premium subsidy amount• Converting to enhanced benefit

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Plan Terminating CMS letter in late October BLUE PAPER version 1

Current plan is leaving Medicare ProgramReassigned to new plan effective January 1, 2008

• Unless they join a new plan by December 31, 2007

ActionKeep the noticeCompare new 2008 plan with othersCan choose to change plans

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Premium Increase

CMS letter in late October BLUE PAPER version 2

Current plan’s premiums increasing by more than $1 over LIS benchmark, or converting to enhanced

Reassigned to new plan effective January 1, 2008• Unless they join a new plan by December 31, 2007

ActionKeep the noticeCompare new 2008 plan with othersCan choose to change plans

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How CMS Reassigns

Attempt to find another planSame organizationNo premium liabilityPromotes continuity

Reassigned randomly if none availableWith plan below LIS

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“Choosers”

LIS with 100% premium subsidyChose plan in 2006 or 2007

And

Have premium increase over $1

CMS will conduct outreach Will not reassign

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“Choosers”

CMS LIS letter in OctoberPremium is rising by more than $1 in 2008Responsible for paying a portion unless they

join a new planAction

May want to look for a new planCompare current plan with othersCan choose to change plans

• Early December is best time

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Potentially Eligible

Social Security letter in late NovemberTo people in Medicare Savings ProgramsExtra help available for drug plan costsAction

• Apply if you think you qualify for extra help• Get more information from Social Security

1-800-772-1213 (TTY 1-800-325-0778)

Resources to Help You

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LIS Toolkit

CMS Outreach StrategyBest practices from around the nation Maps to find those who need helpPhoto novellasPractical tools for counselorsOther helpful resources

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Enrollment Toolkit

How to help Basic Part D education How current coverage works with Part D Choosing and joining a plan Extra help Additional resources

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Enrollment Resources

Personalized web toolsOn www.medicare.gov

• Medicare Prescription Drug Plan Finder• Medicare Options Compare

Partner support• On www.cms.hhs.gov/Partnerships• Mailings to people with Medicare• Publications for partners• Toolkits

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Training Resources

Training on personalized web toolsDesigned for different purposes/audiences

Drug Plan Finder WebinarVideosOnline

www.cms.hhs.gov/NationalMedicareTrainingProgramIncludes links to materials mentioned here

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Important Dates

September 10-25 SSA mails redetermination letters to certain LIS applicants

September 17-20 GREY LETTER mailed to those losing deemed status

October 1 Plans begin marketing

October 2 Terminating plans notify members

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Important Dates

Mid October Drug Plan Finder with 2008 plan data available

Mid October ORANGE LETTER to those deemed for LIS for next year, but copayment will change

By October 31 Annual Notice of Change sent

By October 31 Medicare & You handbook mailed

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Important Dates

Late October BLUE REASSIGNMENT LETTERS mailed

Late October Choosers letter mailed

November 15 Enrollment for 2008 begins

December 31 Enrollment period ends

This training module provided by the

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