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Volume 12 Number 184 News: Part D Drug Benefit Although fewer beneficiaries will lose their automatic receipt of the Medicare Part D low-income subsidy (LIS) in 2008 than in 2007, low-income beneficiaries could, for the first time, face termination of financial help for their prescription drugs if they fail to return a government eligibility query, Centers for Medicare & Medicaid Services staff said Sept. 20. Sharon Donovan, a technical director at CMS's Medicare Enrollment and Appeals Group, said that CMS is in the process of sending letters to 447,000 beneficiaries--185,000 fewer than last year--alerting them that they no longer automatically qualify--or are deemed--for the LIS, as of Jan. 1, 2008. Donovan offered the statistics to a meeting of CMS's Advisory Panel on Medicare Education. Deemed status refers to beneficiaries who automatically qualify for Part D subsidies because they are dual Medicare/Medicaid eligibles, partial dual eligibles, are in the Medicare Savings Program (MSP), or receive Supplemental Security Income (SSI). In the fall of 2006, 632,000 beneficiaries who had automatically qualified for financial assistance with premiums, coinsurance, and copayments in 2006--the first year of the Part D drug benefit--were told they no longer would be "deemed" as of Jan. 1, 2007. Donovan said beneficiaries losing their deemed status will be encouraged to apply for help through the Social Security Administration or their state Medicaid office. They subsequently may regain LIS by requalifying for Medicaid, MSP, or SSI or by applying for the LIS through Social Security. Donovan said that as of June, 60 percent of the 632,000 beneficiaries who lost their deemed status for the 2007 benefit year regained the LIS by applying on their own. CMS each fall re-establishes eligibility for those who are deemed. The loss of deemed status could be due to a change in their personal circumstances, or in various state Medicaid requirements. Because the requirements for the federal LIS are less stringent than those of some states, they could be still eligible for federal help. However, on a related matter, she said that during the upcoming benefit year, low-income beneficiaries will face a "big change" in relation to the Social Security Administration's redeterminations of eligibility for extra help. The SSA is about to send out 500,000 letters with "income and resources summary" sheets to those who receive the LIS. "Last year, if you got the letter and did nothing, nothing happened to you," Donovan said. This year, if a beneficiary does not return the material within 30 days, their LIS could be terminated
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