Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs

As required by the Medicare Modernization Act of 2003 (P.L. 108-173), SSA conducts low-income subsidy eligibility redeterminations for Medicare beneficiaries who filed for the subsidy and were determined by SSA to be eligible. SSA conducts subsidy eligibility redeterminations under two circumstances: 1) When an individual completes Form SSA-1026-OCR-SM-SCE to report a subsidy-changing event (marriage, separation from a spouse, separated spouses resume living together, divorce, annulment, or death); and 2) When SSA uses Form SSA-1026-OCR-SM-REDE to conduct an annual review of individuals who became entitled during the prior 12 months, an annual review of a percentage of individuals who are eligible for more than 12 months, and a review of individuals who report a change in income, resources, or household size that may affect the subsidy amount. We are doing a non-substantive change request to replace the Health Insurance Claim Number (HICN) with the new Medicare Beneficiary Identifier (MBI).

The latest form for Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs expires 2021-05-31 and can be found here.

SSA- 1026-REDE SSA Review of Your Eligibility for Extra Help

Federal Enterprise Architecture: Income Security - General Retirement and Disability

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