The system evaluates the Initial Extra Help redetermination cases selects some for
initial redeterminations in August every year. The selection criteria includes beneficiaries,
both individuals and couples, who became eligible from May of the prior year through
April of the selection year.
For example, the initial redetermination process completed in August 2014 selected
from beneficiaries who became eligible from May 2013 through April 2014. The System
selects these beneficiaries for an initial redetermination if they have not already
had a subsidy-changing event (SCE) or Other Event reported between May and December
of 2013. SSA uses agency data in all cases.
The beneficiary selected for an initial redetermination will receive an SSA-1026-OCR-SM-REDE (Social Security Administration Review Of Your Eligibility For Extra Help). The selection
Cases where agency data indicate a potential change in Extra Help;
Beneficiaries who reported an Other Event between January and the redetermination
selection date in August;
Beneficiaries who did not respond to an Office of Quality Review (OQR) report finding
during the review period;
Beneficiaries whose records had errors OQR found during the OQR review;
Members of a couple who have different Extra Help filing dates, different Extra Help
levels, or a spouse who reported an SCE; and
Cases that fall into the category of special outreach, if any, for the year.
NOTE: SSA excludes anyone who CMS deems eligible for Extra Help, previously reported an
SCE, or had a no-error OQR result.