Medicare Modernization Act (MMA)

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (P.L. 108-173) legislative history, enacted December 8, 2003, required SSA to undertake a number of additional Medicare-related responsibilities. These responsibilities included making low-income subsidy determinations under the new Medicare Part D, notifying individuals of availability of Part D subsidies, withholding Part D premiums from monthly benefits for those beneficiaries who request such an arrangement, and enrolling TRICARE beneficiaries in Medicare Part B. The law also required, beginning in 2007, that Part B Medicare beneficiaries with modified adjusted gross incomes over certain thresholds pay a higher premium than individuals with lesser incomes. SSA was charged with making these determinations.

The MMA requires SSA to make periodic redeterminations of "extra help" eligibility for individuals currently receiving cost-sharing assistance. In August 2009, over 100,000 beneficiaries were selected for such redeterminations. These individuals will receive redetermination forms (SSA-1026) in September 2009. More information on the "extra help" redetermination process is available here.

For these redeterminations, we are using a new version of the SSA-1026, excluding questions about help with household expenses and the value of life insurance. These changes are in accordance with the Medicare Improvements for Patients and Providers Act of 2008.

SSA continues to search for ways to reach individuals who are potentially eligible for the low income Part D subsidy. For more information on these efforts, click this link to the Medicare outreach.

Social Security provides additional outreach resources for individuals and organizations working to assist the public with the prescription drug “extra help” program (also known as the Medicare Part D Subsidy). The page, Information for Organizations, contains an online tool that can be used to assess an individual’s potential eligibility for a subsidy, copies of outreach posters, and additional training materials.

On December 30, 2005, final rules were published in the Federal Register explaining SSA’s policies for making low-income subsidy determinations under the new Medicare Part D. A summary and a copy of the regulations is available here.