CMS Pub. 100-16, ch. 4, § 200.6

In its education and enrollment assistance programs, the MAO must include the

following elements in its written and oral communications with plan enrollees:

• Clarification that the enrollee may voluntarily offer information, including financial

information, for assistance with enrolling in or maintaining enrollment in state

financial assistance, but that the enrollee is not obligated to provide this information.

• Clarification that the enrollee’s failure to provide information will in no way

adversely affect the enrollee’s membership in his or her health plan.

• Clarification that the Medicare Savings Programs are part of either the “State

Medicaid program” or “State medical assistance programs.”

• Clarification that the plan sponsor is only providing an initial eligibility screening

and that only the appropriate State Agency can make a final eligibility determination.

• Guidance to an enrollee on how to proceed with the application process even if the

MAO’s screening process indicates that the enrollee is probably not eligible for

assistance under any of the dual eligibility programs.

• Alternate sources of information, including the telephone number for enrollees to call

the SHIP and the appropriate State Agency. Outreach materials may also include the

1-800-MEDICARE (1-800-633-4227) number and the (1-800-486-2048) TTY number.

The MAO must coordinate its education and enrollment efforts with the appropriate State

Medicaid Agency and local SHIP offices so that these entities are aware of the MAO’s

efforts.

MAOs may provide assistance to the enrollee in completing applications for financial

assistance including submitting the paperwork to the appropriate State office.