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West Virginia Income Maintenance Manual Chapter 8

West Virginia Income Maintenance Manual Page 11 Chapter 8 Resource Development

the premium from his income. See Section 23.12 for Medicaid coverage groups for Medicare premium payments. 8.6.2.C Medicare Part D – Medicare Prescription Drug Benefit An individual who is already enrolled in Medicare Part A or Part B may receive the Medicare Prescription Drug Benefit. The Part D Prescription Drug Benefit is not administered by the SSA. The benefit is obtained by enrolling in a Prescription Drug Plan (PDP). Enrollees may pay a monthly premium, unless financially qualified for extra help, also known as the Low-Income Subsidy (LIS). The extra help pays all or part of the drug benefit premium, co-pays, and deductibles that may be required. Workers must assist individuals who request LIS complete the LIS application. The application must be submitted on an original SSA form, the SSA-1020-OCR-SM, or submitted on the internet at www.ssa.gov/prescriptionhelp/. Medicaid clients enrolled in Medicare automatically qualify for the extra help and will be automatically enrolled in a PDP. With a few exceptions, Medicaid will not pay for prescription drugs for individuals age 65 or over who are eligible for and do not enroll in a PDP. This also applies to Medicare-enrolled individuals under age 65 who are identified by the Department of Human Services (DOHS). Additional information about the Prescription Drug Benefit and extra help is available at www.ssa.gov and www.medicare.gov. 8.6.2.D Automatic Enrollment of Individuals in Medicare In the following circumstances, an individual is automatically enrolled in Medicare Part A. He is also automatically enrolled in Part B unless he specifically declines enrollment. • When the individual is receiving RSDI, he is automatically enrolled by the SSA when he becomes eligible. • When the individual is receiving Railroad Retirement Benefits, he is automatically enrolled by that Board when he becomes eligible. Individuals who are automatically enrolled by the SSA are not referred for enrollment. However, at the time of application and redetermination, the Worker must identify each client who will be automatically enrolled before the next redetermination. The client must be asked to notify the