LTBB Medicare Reimbursement Program

The Medicare Reimbursement Program is available to all LTBB Citizens nationwide.

Maximum payment for Part B - Current CMS published rate for Part B standard monthly premium (this does not include adjusted rates due to income or penalty)

Maximum payment for Part D - $75 per month 

Two payments are issued each calendar year, in the order they are received:

    -Application processing for the first payment: opens January 1st - February 14th deadline

          -Covers expenses from July 1st-December 31st of the prior year

    -Application processing for the second payment: opens July 1st - August 14 deadline

          -Covers expenses from January 1st - June 30th of the current year

*** Late submissions are denied***

Applicants must complete the application and submit:

- Copy of Medicare card

- Part B: a copy of your Social Security benefits letter showing the Part B deductions -OR- bank account/credit card statements showing the payment

- Part D: a copy of your prescription insurance card AND bank statement/statement from your insurance plan showing you paid for your plan

PLEASE NOTE: Incomplete applications will not be processed unless the applicant submits all required documentation before the deadline

What would you like to be reimbursed for: *
Signature *
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For Part B Reimbursement:

For Part D Reimbursement:


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