The Medicare Improvements for Patients and Providers Act of 2008 becomes effective
                  January 1, 2010. MIPPA changes include the elimination of in-kind support and maintenance
                  as income and the cash surrender value of life insurance as a resource for Extra Help
                  purposes. Under MIPPA, a claimant’s identity and financial information used in the
                  Extra Help determination is transmitted to their state Medicaid agency to initiate
                  a Medicare Savings Programs application unless the claimant objects.
               
               In some cases, the claimant should file an Extra Help application effective January
                  2010 to take advantage of the statutory changes.