2615. Redeterminations

There are no mandatory reporting rules in the program for extra help with Medicare prescription drug costs. However, the law requires that SSA periodically redetermine a person's continuing eligibility for extra help with Medicare prescription drug costs and the amount of that extra help. We will schedule a redetermination of a person's eligibility for the extra help about a year after eligibility began. Each year, we will select cases for redetermination in the period August through December, rather than throughout the year. The redeterminations will generally be conducted by mail rather than face-to-face. Also, if you experience one of the events in section 2615.1, you may want to request a redetermination if the event reduces your income and/or resources.

2615.1 What events can result in a redetermination of the amount of extra help you receive before the periodic redetermination?

1. You get married;

2. You and your spouse who lives with you divorce;

3. Your spouse who lives with you dies;

4. You and your spouse separate;

5. You and your spouse have your marriage annulled; or

6. You and your spouse begin living together again.

2615.2 What happens to your extra help with Medicare prescription drug costs after you notify SSA of an event?

Certain changes in your situation (above) may affect the amount of extra help that you can receive to pay for your prescription drug costs. Based on the event and circumstances reported, SSA may adjust the amount of extra help you receive.

Last Revised: Apr. 18, 2006