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Costs

• Late Enrollment Penalty Premiums - About Them

  CMS requirements regarding lapses of credible drug coverage that lasted more than 63 days after the end of the member’s Initial Enrollment Period: a guidance (50Kb PDF file) that CMS updated in June 2007.

• Late Enrollment Penalty Premiums - Updated Guidance (April 2008)

  CMS issued updated Guidance on creditable drug coverage and late enrollment penalty premiums in April 2008.

• Late Enrollment Penalty Premium Decisions - Appealing Them

  Here is the CMS guidance (55Kb PDF file) on appealing late enrollment penalty premium decisions.

• Part D Plan Premium Withholding By Social Security

  CMS clarified in Withholding and Secondary Coverage (50Kb PDF file) that Social Security can only deduct full Part D plan premiums.

• Reimbursement for Out-of-Pocket Premiums and Co-payments

This CMS Tip Sheet from June 2007 describes how to seek reimbursement from Part D plans for premiums and co-payments that plan members should not have had to pay.

• True Out-of-Pocket Payments, or TROOP (CMS, December 2007)

  This CMS Tip Sheet explains what is and is not TrOOP and how TrOOP works when a beneficiary changes Part D plans mid-year.