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Tools You Can Use
ABC offers a wide variety of tools to make it easy for state/local coalitions, national organizations and their affiliates, local community-based organizations and others to help Medicare beneficiaries with limited incomes reduce the costs of their prescription drugs. Documents are available in either MS Word or PDF formats. Word documents can be opened and saved to your computer where you can edit them. PDFs are easy to save and print, but you can not edit them. To view PDFs you must have Adobe Acrobat Reader.
Training and Technical Assistance Tools
Medicare Part D Low-Income Subsidy
Medicare Prescription Drug Benefit (Part D)
Coalition Building
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Decision Support Tools
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ABC Communications Support Tools
For National Coalition Members
For State/Local Coalitions and Other Organizations
Materials including press release templates and radio public service announcements, plus posters in many languages that can be printed out on office printers.
Training and Technical Assistance Tools
Find useful information here to help you help people with Medicare in your community get the most savings they can on their prescription drugs.
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Medicare Part D Low-Income Subsidy
Fact Sheets and Issue Briefs:
Fact Sheet on the Social Security Administration's Follow-up Calls with Those Not Responding to the LIS Mailing: These resources developed by SSA discuss vendor procedures to be used for follow-up telephone calls being made to individuals who have not responded to the initial mailing of the application.
Update on the CMS Mailing: This update developed by CMS provides information for people assisting those with limited incomes and resources about mailings to people with Medicare about help with paying for prescription drugs.
Regional CMS Contact List: This list provides contact information for regional Centers for Medicare & Medicaid Services (CMS) staff with whom partnerships can be developed to reach and enroll people with Medicare in the low-income subsidy and ultimately drug plans.
Map of CMS Regions: This map shows states included in each Centers for Medicare and Medicaid Services (CMS) region. It also contains telephone numbers for regional CMS and SSA offices.
Regional Social Security Administration Contact List: This list provides contact information for regional Social Security Administration Communications directors with whom collaborations can be formed to educate, reach and help people apply for the low-income subsidy.
CMS's Regional Education About Choices in Health Program (REACH) Office Contact List: This document provides regional contact information for CMS's REACH program, and also includes regional contact information for CMS's Medicare Modernization Act (MMA) education campaign.
Fact Sheet on Other Federal Means-Tested Programs and the Low-Income Subsidy: This fact sheet developed by CMS illustrates how the Part D low-income subsidy affects someone who qualifies for several federal means-tested programs.
Fact Sheet on Food Stamps and the Low-Income Subsidy: This fact sheet developed by CMS provides information on how the Part D low-income subsidy may affect those who qualify for Food Stamps.
Fact Sheet on Housing Assistance and the Low-Income Subsidy: This fact sheet developed by CMS provides information on how the Part D low-income subsidy may affect those who qualify for housing assistance.
Fact Sheet on Medicaid Spend Down and the Low-Income Subsidy: This fact sheet developed by CMS provides information on how the Part D low-income subsidy may affect those who “spend down” to qualify for Medicaid.
Quick Facts for People with Limited Income and Resources: This fact sheet developed by CMS provides a brief overview of the low-income subsidy, how to apply for it and where to go for additional information.
Quick Facts for People who Applied for Extra Help: This fact sheet provides information for those who applied for the low-income subsidy, including what happens next and who to contact with additional questions.
Face and Cash Values of Life Insurance Fact Sheet: This one-page fact sheet from the Social Security Administration contains information on life insurance values which may be needed when filling out the low-income subsidy application form.
Fact Sheet about Extra Help with Prescription Drug Plan Costs: This fact sheet developed by the Social Security Administration provides an overview of the extra help available under the new Medicare Prescription Drug Coverage.
Fact Sheet of Key Dates for the Low-Income Subsidy: This fact sheet developed by CMS includes key dates for beneficiaries who may be eligible for extra assistance with their prescription drugs. It provides an understanding of when applications will be available, when they will know whether they are eligible for the low-income subsidy and dates regarding plan enrollment.
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Flyers and Posters:
SSA Medicare Outreach Posters for the Low-Income Subsidy: The Social Security Administration has released four poster designs for community outreach for the low-income subsidy.
SSA Medicare Outreach Posters in Different Languages: The Social Security Administration has released Medicare outreach posters in 15 languages: Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese.
PowerPoint Presentations:
Implementing Cost-Effective and Efficient Outreach and Enrollment Methods (August Training): This PowerPoint presentation was provided during an August training session conducted by ABC national office staff.
It provides practical guidance on how to select and implement the most cost-effective and efficient practices for your enrollment activities and how to continuously improve your efforts over time. This session builds upon the lessons learned from ABC’s benchmarking study.
Dual Eligibles and Medicare Part D (July Training): This PowerPoint presentation was provided and presented by Vicki Gottlich and Trish Nemore from the Center for Medicare Advocacy, a national ABC member. It provides information on issues for the dual eligible population as they relate to the new Medicare Prescription Drug Coverage.
The Low-Income Subsidy Appeals Process (June Training): This PowerPoint presentation was provided and presented by Vicki Gottlich and Brad Plebani from the Center for Medicare advocacy, a national ABC member. It provides a detailed overview of the appeals process for the low-income subsidy.
A Walk Through of the Low-Income Subsidy Application (May Training): This PowerPoint presentation was provided during a May training session conducted by ABC national office staff. It provides guidance with filling out the application for extra help with prescription drug plan costs for people with limited incomes and resources.
Overview of the Low-Income Subsidy Presentation (April Training Session): This PowerPoint presentation was provided during an April training session conducted by ABC national office staff. It provides a detailed look at the low-income subsidy.
Low-Income Subsidy Presentation: This PowerPoint presentation provides overview of the Part D low-income subsidy given by the ABC national office staff.
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Worksheets:
Sample of Auto-Enrollment Letter CMS Sent to the Full-Benefit Dual Eligible Population: This sample auto-enrollment letter, and accompanying questions and Answers, lets beneficiaries know the Medicare prescription drug plan in which they will be enrolled if they do not take any action prior to January 1.
Sample Worksheets Used to Calculate Income and Resource Eligibility for the Low-Income Subsidy for People with Medicare: This worksheet is a sample of what will be sent to people with their denial and award notices for the low-income subsidy. It shows how their income and resources were calculated and used in the determination process.
Sample Award Notice to Be Sent to People with Medicare Determined to Be Eligible for the Low-Income Subsidy: This letter is a sample of what will be mailed to people with Medicare who SSA determines are eligible for the low-income subsidy. This notice provides the subsidy level the individual will receive, as well as information used to make the decision, how to appeal the decision and how to enroll in a Medicare prescription drug plan.
Sample Denial Notice to Be Sent to People with Medicare Not Eligible for Low-Income Subsidy: This letter is a sample of what will be mailed to people with Medicare who SSA determines are not eligible for the low-income subsidy. This notice provides reasons for the denial, as well as information on how to appeal the decision and enroll in a Medicare prescription drug plan.
Sample SSA Application Form for the Low-Income Subsidy: This form is a sample application form for help with Medicare Drug Plan Costs for those with limited incomes and resources.
Sample SSA Application Form for Low-Income Subsidy Translated into 14 Languages: Translations of the application form are available in 14 languages, but they must be completed in English.
Worksheet to Determine Income and Asset Sources to be Counted When Applying for the Low-Income Subsidy: This worksheet developed by the Health Assistance Partnership which lists sources of countable income and assets that should be included when determining someone's eligibility for the Medicare Part D low-income subsidy.
SSA Worksheet on Income and Asset Information Needed to Apply for the Low-Income Subsidy: The Social Security Administration developed this document to help those applying for the subsidy. It lists the documents they may need to fill out the application and provides a worksheet to help beneficiaries and people assisting them with the application determine their income and assets.
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Tool Kits and Tutorials:
Applying for the Low-Income Subsidy: A Tool Kit for Advocates Assisting People with Medicare: This Tool Kit, developed by the Access to Benefits Coalition, includes useful resources to assist you with helping people apply for the low-income subsidy. The Tool Kit includes a guide and frequently asked questions developed by the Access to Benefits Coalition, and important information you should have from the Social Security Administration
CMS Guidance to States on the Low-Income Subsidy: This resource provides information on the application process for the low-income subsidy is people go to state Medicaid offices instead of Social Security offices to apply.
SSA Manual for the Low-Income Subsidy Application Process: The Social Security Administration provided states with this 95-page manual to assist with the low-income subsidy application process. The manual provides a background on the Part D benefit and the low-income subsidy, statutory and regulatory information, components of the LIS application form and state resources.
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Medicare Prescription Drug Benefit (Part D)
Fact Sheets and Issue Briefs:
Fact Sheet on Enrollment Reconciliation: CMS is now taking steps to ensure that all beneficiaries who changed plans are appropriately disenrolled from their initial plan by April 30, 2006. This process of reconciling plan enrollments will assure consistent coverage, allow appropriate tracking of out-of-pocket costs, permit payments to be fully reconciled between plans, and most importantly, ensure that each beneficiary continues to receive drug coverage smoothly and consistently.
Facilitated Enrollment Notice/Letter mailed to beneficiaries: One is for those who qualify for the full subsidy and one for those who qualify for the partial subsidy.
Fact Sheet on Extension of Transitional Drug Coverage Period:
This fact sheet prepared by CMS announces that plans will be extending the 30-day transitional drug coverage period from the 30-day period to an additional sixty (60) more days.
Fact Sheet on the Transition of the Dual Eligible Population to Medicare Part D: This fact sheet prepared by CMS provides information on how full-benefit dual eligibles will move to comprehensive Medicare prescription drug coverage.
Fact Sheet on the Extra Help and the Basic Premium: This fact sheet developed by CMS explains how the extra help applies to Medicare drug plans with an enhanced alternative option.
CMS Partnership Document Addresses Qualified Covered Retiree Issues: This partnership document, released by CMS, discusses who is a qualifying covered retiree. This document discusses several frequently raised issues about the definition of qualifying covered retiree, including how the rules apply to spouses, dependents and individuals eligible for Medicare coverage due to disability or end stage renal disease.
CMS Auto-Enrollment Notice:
This notice, devised by CMS informs people with Medicare and full Medicaid coverage (full-benefit dual eligibles) about the change in their drug coverage from Medicaid to Medicare.
State-Specific and National Information on Medicare Part D Plan Approvals: This link to the CMS web site site includes state-specific information on stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage PDPs to be offered, as well as national offerings.
Fact Sheet on Things to Think About When Comparing Medicare Prescription Drug Plans: This fact sheet developed by CMS provides guidance on things to think about when comparing drug plans.
Fact Sheet on Comparing Medicare Prescription Drug Coverage: This fact sheet developed by CMS provides information on comparing Medicare prescription drug plans. This fact sheet is available in both English and Spanish.
Fact Sheet on How to Join Medicare Prescription Drug Coverage: This fact sheet developed by CMS provides information on how to join Medicare prescription drug coverage. It is available in both English and Spanish.
Fact Sheet on Benchmark Premium Amounts: This fact sheet developed by CMS lists
the average benchmark premiums for each region.
Fact Sheet on
Prescription Drug Plan (PDP) Organizations Eligible for Auto Enrollments: This fact sheet developed by CMS shows the number of PDP organizations eligible for auto enrollment, by PDP region.
Fact Sheet on Average Regional Premium Costs: This fact sheet developed by CMS shows the
preliminary number of stand-alone PDPs with monthly premiums in different ranges and weighted-average monthly premium for each PDP region.
Quick Facts for People with a Medigap (Medicare Supplement Insurance) Policy about Medicare’s New Prescription Drug Coverage: This fact sheet developed by CMS provides information that people with Medigap coverage should have to make important decisions about their prescription drug coverage.
Fact Sheet on TRICARE Benefits and the New Medicare Prescription Drug Coverage: This fact sheet developed by CMS provides information that people with TRICARE benefits should have to make important decisions about their prescription drug coverage.
Fact Sheet on Veterans' Administration (VA) Benefits and the New Medicare Prescription Drug Coverage: This fact sheet developed by CMS provides information that people with VA benefits should have to make important decisions about their prescription drug coverage.
Fact Sheet on the Five Main Audiences for Outreach: This fact sheet developed by CMS explains who the five key audiences are that you may deal with, and information each group may need about the Medicare Prescription Drug Coverage.
Quick Facts about Medicare Prescription Drug Coverage and Protecting Personal Information: This fact sheet developed by CMS explains to people with Medicare how to best protect their identity in dealing with plans and others about Medicare Prescription Drug Coverage.
Fact Sheet Explaining who Can Help People Enroll in Medicare Part D: This fact sheet developed by CMS explains to people with Medicare who can help them apply for extra help in paying for prescription drug costs and who can help them enroll in a Medicare prescription drug plan.
Fact Sheet about Medicare's New Coverage for Prescription Drugs for People who have Prescription Coverage from an Employer or Union: This fact sheet developed by CMS provides information on how employer or union prescription drug coverage will work with Medicare Part D.
Fact Sheet about Medicare's New Coverage for Prescription Drugs for People with a Medicare-approved Drug Discount Card: This fact sheet developed by CMS provides information on what will happen to Medicare-approved drug discount cards when Medicare Part D coverage becomes effective.
Fact Sheet about Medicare's New Coverage for Prescription Drugs for People with a Medicare Health Plan with Prescription Drug Coverage: This fact sheet developed by CMS provides information on how Medicare Health Plans will work with Medicare Part D.
CMS Web Page Contains Helpful Medicare Modernization Act (MMA) Materials: This web page provides helpful information about the Part D low-income subsidy, general MMA information and resources for SHIPs and community-based organizations, states and providers.
Fact Sheet on Medicare Prescription Drug Coverage (Part D): This fact sheet developed by CMS provides basic information on Medicare prescription drug coverage that begins in January 2006.
Fact Sheet on Medicare Prescription Drug Coverage (Part D) for People Living in Nursing Homes or Other Long-Term Care Facilities: This fact sheet developed by CMS provides information on the Medicare Prescription Drug Coverage for people living in nursing homes or other types of long-term care facilities, including what they need to understand about the benefit and where to go for additional information.
Fact Sheet on Medicare Prescription Drug Coverage (Part D) for People Receiving Help from State Pharmacy Programs to Pay for Their Prescription Drugs: This fact sheet developed by CMS provides information on the Medicare Prescription Drug Coverage for people receiving help with prescription drug costs through state pharmacy programs, including what they need to understand about the benefit and where to go for additional information.
Fact Sheet on Medicare Prescription Drug Coverage (Part D) for People with Medicaid and Medicare (Dual Eligibles): This fact sheet developed by CMS provides information on the Medicare Prescription Drug Coverage for people receiving Medicare and Medicaid who receive help with prescription drug costs through Medicaid, including how their Medicaid prescription drug overage is changing and where to go for additional information.
Fact Sheet on Medicare Prescription Drug Coverage (Part D) for People Receiving Supplemental Security Income (SSA) Benefits or Help from State Medicaid Programs with Paying Medicare Part B Premiums (Medicare Savings Programs): This fact sheet developed by CMS provides information on the Medicare Prescription Drug Coverage for people receiving SSI benefits or help paying for Medicare Part B premiums through state Medicaid programs, including what they need to understand about the benefit and where to go for additional information.
CMS Calendar of Important Dates: This calendar provides important dates in 2005 and 2006 related to Medicare Prescription Drug Coverage for Medicare beneficiaries.
CMS Preferred Terms List: To help you with terminology used when talking about Medicare Part D, CMS has developed a preferred terms list.
Fact Sheet on Automatic versus Facilitated Enrollment in Medicare Part D Plans: This fact sheet illustrates the processes for both automatic and facilitated enrollment of low-income populations into Medicare Part D plans.
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Frequently Asked Questions (FAQs):
Plan Enrollment Data by County: CMS recently released PDP plan enrollment data by county.
Scenarios People with Medicare May Face During Their First Visit to the Pharmacy: This chart of potential scenarios illustrates issues that different beneficiary populations (e.g., dual eligibles, LIS enrollees, those with retiree coverage and more) may face as they go to the pharmacy for the first time.
FAQs About Retiree Prescription Drug Coverage and the New Medicare Prescription Drug Coverage: This FAQ sheet developed by CMS provides information those with retiree prescription drug coverage should have to make important decisions about their prescription drug coverage.
CMS Answers Questions on Medicare Prescription Drug Coverage: This resource provides up-to-date answers to frequently posed questions about prescription drug coverage under Medicare Part D.
PowerPoint Presentations:
ABC Preconference Presentations: These PowerPoint presentations from a one-day special program sponsored by the national ABC office include promising practices in outreach, education, decision support and enrollment used by ABC coalitions and discussion about what the Medicare drug benefit means for the aging network.
Effective Use of Volunteers with Medicare Prescription Drug Coverage (March 2006 Training): This training session on how to effectively use volunteers included presentations from Alyson Burns of Ogilvy Public Relations Worldwide, Lisa Federico representing the Atlanta ABC coalition and Bob Quirk representing the Seattle ABC coalition.
Dual Eligible Transition Issues (February 2006 Training): This training session was presented by Trish Nemore of the Center for Medicare Advocacy to discuss issues and potential solutions around the transition of dual eligibles into Medicare Prescription Drug Coverage.
Part D Exceptions and Appeals Process (January 2006 Training): This training session was presented by Vicki Gottlich and Pam Meliso of the Center for Medicare Advocacy. A powerpoint presentation was provided as well as two notices: coverage notice denial and a pharmacy notice describing appeal rights.
Part D and Managing Liability (December Training): This training session was presented by Hilary Dalin of the Health Assistance Partnership. Many materials related to managing liability issues were provided, including fact sheets on: protecting counselors from liability, counseling 'dos' and 'don'ts', helping cognitively impaired clients, as well as sample client intake forms, liability statements and liability forms you might use as templates in your work.
Assisting People with Medicare with
Part D Selection and Enrollment Decisions: Where Do We Begin? (October Training): This PowerPoint presentation was developed by staff at the national ABC office to provide guidance on how to begin talking with clients about Medicare Prescription Drug Coverage plan decisions.
Medicare Part D:
Issues for People with Other Prescription Drug Coverage (September Training): This PowerPoint presentation was provided and presented by Vicki Gottlich from the Center for Medicare Advocacy, a national ABC member. It provides information on how employer/retiree insurance and Medigap relate to the new Medicare Prescription Drug Coverage.
CMS Medicare Prescription Drug Coverage PowerPoint Slides: These slides, developed by CMS, serve as an educational tool for all health care professionals to learn more details about the Medicare Prescription Drug Coverage program. Both an expanded version and an abbreviated version of these slides is available.
Spanish-Language Training Materials on Medicare Part D: These resources, developed by CMS, can assist those working with Spanish-speaking populations:
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Overview of Medicare Part D and the Extra Help Available: This PowerPoint presentation was developed by staff at the national ABC office to provide an overview of the Medicare Prescription Drug Coverage.
SSA Medicare Prescription Drug Benefit (Part D) Program Orientation Presentation: This PowerPoint presentation provides an overview of the Medicare Prescription Drug Benefit program and components of the low-income subsidy application.
Lessons Learned from ABC Coalitions PowerPoint Presentation: This PowerPoint presentation shares learnings from ABC coalitions' experiences in getting beneficiaries enrolled in the transitional assistance benefit and discount drug cards.
ABC Preconference Presentations: These PowerPoint presentations from a one-day special program sponsored by the national ABC office include promising practices in outreach, education, decision support and enrollment used by ABC coalitions and discussion about what the Medicare drug benefit means for the aging network.
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Tool Kits and Tutorials:
Medicare Drug Coverage Transitional Tool Kit: To help counselors, health care providers and others who care for people with Medicare, CMS has developed training and educational materials about the transition period.
"My Medicare Matters" resource: My Medicare Matters is a new, comprehensive national education program to help people with Medicare and their families understand the new Medicare Prescription Drug Coverage, assess their personal situation, understand their choices, compare plan options and make the enrollment decision that is right for their health and their financial situation. It is sponsored by The National Council on the Aging and the Access to Benefits Coalition, with support from AstraZeneca Pharmaceuticals LP.
Medicare Part D Consumer Tip Sheets Available in 5 Languages: The National Consumer Protection Technical Resource Center has an online resource center that includes two Medicare Part D Consumer tip sheets that have been translated into five different languages.
Links to this information are also included on The Center’s homepage of the website under “Features.”
Medicare Prescription Drug Coverage Outreach Toolkit: The Centers for Medicare and Medicaid Services (CMS) have released a toolkit designed to equip community-level organizations with the materials needed to provide clear, accurate information and assistance to their clients on the Medicare prescription drug coverage. The toolkit is developed with basic, straightforward information that can be easily conveyed to beneficiaries.
Guides for Navigating Medicare and Medicaid: Published by the Kaiser Family Foundation, these guides offer assistance to people with disabilities, their families and advocates on how to apply for coverage under Medicare or Medicaid, how to appeal Medicare coverage decisions, and how they can keep Medicare and Medicaid coverage when they work.
Medicare Prescription Drug Benefit Tutorial: This tutorial, developed by the Kaiser Family Foundation, explains the new Medicare prescription drug law, reviewing the major provisions, including the discount card, private plans, the "doughnut hole," and subsidies for low-income beneficiaries.
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Coalition-Building
Fact Sheets and Issue Briefs:
Building Coalitions: This Issue Brief, published by the Center for Medicare Education, explores the topic of coalition-building, focusing on specific " how-to's " and using real-life examples from the experiences of the Coalition to Monitor Medicare Managed Care in Cleveland, OH.
Worksheets:
Asset Inventory Document: Use this document to assess the strengths and capabilities of your coalition members. (This document was adapted by the Alzheimer ' s Association from Organizing for Social Change, Midwest Academy, Chicago, IL .)
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Decision Support Tools
Online Qualifier Tool for the Low-Income Subsidy: The Social Security Administration has developed a Qualifier Tool for Medicare beneficiaries and those who help them to assess whether they qualify for extra help with prescription drug costs.
BenefitsCheckUpRx™
Use this powerful, Web-based decision support tool to help people with limited incomes and resources learn about and enroll in the combination of public or private prescription savings programs that will save them the most money. Once the questionnaire is completed, you will get a confidential, personalized report that tells you what programs they qualify for and the application forms to apply for them. Click here to go to BenefitsCheckUpRx now.
BenefitsCheckUpRx Organizational Edition
Local Access to Benefits Coalition member agencies and local affiliates of National ABC member organizations may sign up for an Organizational Edition (OE) of BenefitsCheckUpRx™. OE provides agencies using BenefitsCheckUpRx™ some extra tools that make it easier to screen, enroll and follow up with clients who are eligible to receive Rx assistance. To log into the Organizational Edition, click here. To learn more about the Organizational Edition, click here.
BenefitsCheckUp®
This program provides a simple and confidential online service for seniors and persons with disabilities, and their caregivers. It searches more than 1,300 federal, state, and private programs for seniors and persons with disabilities to find them help with prescription drug and health care costs, housing assistance, property taxes, gas and electric bills, meals as well as many other needs.
Application Forms Center
Application Forms Center: Find hundreds of prescription savings program, State Medicaid and Medicare Savings Program enrollment forms here. Most forms must be printed and mailed, but some are fillable online.
Workbooks
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ABC Communications Support Tools
For National Coalition Members
Communications materials for use by national coalition members.
Announcements
ABC Posters
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For State/Local Coalitions and Organizations
Materials including press release templates and public service announcements for announcing local Coalitions or other important milestones.
General Materials
Articles and Other Resources
ABC Posters
Links to ABC Web Site
ABC News Release and Media Advisory Templates
ABC Public Service Announcements- radio
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