TN 22 (12-17)

NL 00725.310 “MHP” UTIs – Medicare Health Plan

MHPC02 Caption

Information About  (1)  Health Plan Premiums

Fill-in:

(1) BGN plus BLN possessive/“Your”

MHP015 Award, Claimant Already Enrolled in Medicare Part C or D on another Account

Each month, we will continue to deduct  (1)  for  (2)  health plan premiums.

Fill-ins:

(1) Show the SUM of DAH-AMOUNT associated with DAH-ITEM 445 plus DAH-AMOUNT associated with DAH-ITEM 455 in the format $$$$$.CC

(2) BGN plus BLN (possessive)/ “your”

MHP043 Deduction for Medicare Part D

Each month, we will continue to deduct  (1)  for  (2)  Medicare prescription drug plan costs.

Fill-ins:

(1) PART D premium amount

(2) beneficiary's given name and last name, possessive/“your”

MHP044 Deduction for Medicare Part C and Part D

Each month, we will continue to deduct  (1)  for  (2)  health plan premiums and  (3)  for  (4)  Medicare prescription drug plan costs.

Fill-ins:

(1) PART C premium amount

(2) beneficiary's given name and last name, possessive/“your”

(3) PART D premium amount

(4) “her”/“his”/“your”

MHP053 Information about the Medicare Prescription Drug Plan (Part D)

Now that  (1)   (2)  eligible for Medicare,  (3)  can enroll in a Medicare prescription drug plan (Part D).

To learn more about the Medicare prescription drug plans and when  (4)  can enroll, visit  (5)  or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). Medicare also can tell  (6)  about agencies in  (7)  area that can help  (8)  choose  (9)  prescription drug coverage.

If  (10)  limited income and resources, we encourage  (11)  to apply for the extra help that is available to assist with Medicare prescription drug costs. The extra help can pay the monthly premiums, annual deductibles and prescription co-payments. To learn more or apply, please visit  (12)  , call 1-800-772-1213 (TTY 1-800-325-0778) or visit the nearest Social Security office.

Fill-ins:

(1) Ms. plus BLN/Mr. plus BLN/BGN/BGN plus BLN/“you”

(2) “are”/“is”

(3) “she”/“he”/“you”

(4) “she”/“he”/“you”

(5) “http://www.medicare.gov

(6) “her”/ “him”/ “you”

(7) “her”/“his”/ “your”

(8) “her”/“him”/ “you”

(9) “her”/”his”/”your”

(10) “she has”/“he has”/ “you have”

(11) “her”/“him”/ “you”

(12) “www.socialsecurity.gov


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900725310
NL 00725.310 - "MHP" UTIs - Medicare Health Plan - 12/21/2017