Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs

As required by the Medicare Modernization Act of 2003 (P.L. 108-173), SSA conducts low-income subsidy eligibility redeterminations for Medicare beneficiaries who filed for the subsidy and were determined by SSA to be eligible. SSA conducts subsidy eligibility redeterminations under two circumstances: 1) When an individual completes Form SSA-1026-OCR-SM-SCE to report a subsidy-changing event (marriage, separation from a spouse, separated spouses resume living together, divorce, annulment, or death); and 2) When SSA uses Form SSA-1026-OCR-SM-REDE to conduct an annual review of individuals who became entitled during the prior 12 months, an annual review of a percentage of individuals who are eligible for more than 12 months, and a review of individuals who report a change in income, resources, or household size that may affect the subsidy amount.

The latest form for Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs expires 2026-12-31 and is listed under ICR 202012-0960-009.

SSA- 1026-REDE SSA Review of Your Eligibility for Extra Help

Federal Enterprise Architecture: Income Security - General Retirement and Disability

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