Page 3 – CMCS Informational Bulletin
• Choosers Notice: In early November, CMS will mail tan notices to LIS beneficiaries
who are in a PDP in which they will have a premium liability, but are not being
reassigned by CMS because they actively chose their current plan. CMS refers to these
beneficiaries as “choosers.” Like the blue reassignment notice, the tan “choosers” notice
will inform them of the new monthly premium amount for which they will be liable if
they stay in their current PDP and include a list of PDPs that have no premium liability
for people eligible for the full premium subsidy in 2016.
• Affordable Care Act (ACA) Formulary Notice: In December, CMS will mail a second
blue notice to all LIS beneficiaries who will be reassigned to a new PDP. This includes
those reassigned in the PDP and MA reassignments processes referenced above. This
second notice will identify which drugs in their current drug regimen are covered in the
2016 plan to which they are being reassigned, and how to request an exception to obtain a
drug that is not included in the plan’s formulary.
CMS has created a guide to 2015/2016 mailings sent to consumers from CMS, the Social
Security Administration, and plans. This guide summarizes each notice’s message, explains
when it will be sent, and includes the color of the paper on which the notice is printed. This
guide is available on our Limited Income and Resources webpage at:
https://www.cms.gov/Medicare/Prescription-Drug-
Coverage/LimitedIncomeandResources/index.html
The model beneficiary letters also will be posted on this webpage (in the “LIS Notices and
Mailings” section) as they become available.
State Notification
On or about October 16, 2015, CMS will send two files, if applicable, to each state. The first
will list the LIS-eligible individuals in their state who will receive a blue PDP reassignment letter
and the second file will list the LIS-eligible individuals who will receive a blue MA
reassignment letter. Customer service representatives at 1-800-MEDICARE will be prepared to
answer questions about the reassignment process and about beneficiaries’ full range of options.
In addition, plan information will be available at Medicare.gov.
The reassignment files that CMS sends to states contains a list of full duals, partial duals,
Supplemental Security Income (SSI)-only eligible individuals, and approved LIS applicants
residing in their state who will be receiving blue notices from CMS informing them that they will
be reassigned. Individuals that a State Pharmaceutical Assistance Program (SPAP) has requested
CMS to carve-out of the reassignment process, under the SPAP’s authority to enroll on behalf of
its members, will not be included in this file. This exclusion will ensure that such beneficiaries
are reassigned only once. These reassignments will subsequently appear on the state’s normal
MMA response file starting on or after October 12, 2015. See the attachment for the state
reassignment file layout.
Thank you for your continued assistance with our efforts to ensure that low-income Medicare
beneficiaries, including dual eligibles, maintain affordable and comprehensive coverage under
