Re-Determination of Part D Low-Income Subsidy Eligibility for 2017
Guidance for: The purpose of this memorandum is to provide organizations with information and guidance about:
• The process used by the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) to re-determine Medicare beneficiaries’ low-income subsidy (LIS) eligibility;
• An optional grace period for individuals who will no longer automatically qualify for the
Part D LIS in 2017;
• A special enrollment period (SEP) for individuals who lose their LIS eligibility;
• CMS’ expectations regarding Part D sponsors’ responsibility for conducting outreach to members who no longer automatically qualify for LIS in 2017 and steps sponsors may take
to ease their members’ transition; and
• Two files from CMS to all Part D sponsors identifying individuals who CMS has notified
about their loss of LIS in 2017.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 20, 2016
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.