Social Security Administration. Retirement, Survivors and Disability Insurance Important Information Mid-Atlantic Program Service Center 300 Spring Garden Street Philadelphia, Pennsylvania 19123-2092 Date: December 12, 2016 Claim Number: 200.46-0959HA Hebel tet et eee tw ttt 0051948 001958291 AT 399 1206MITZRZPN 'T735 PIG STANLEY J CATERBONE 1250 FREMONT STREET LANCASTER PA 17603-6812 We are writing to you about your Social Security benefits. What You Should Know There has been a change in the amount withheld for your Medicare prescription drug plan costs. What We Will Pay And When © You will receive $1,379.00 for December 2016 around January 18, 2017. © After that you will receive $1,379.00 on or about the third Wednesday of each month. Information About Your Health Plan Premiums We will no longer deduct money for your health plan premium(s) from your monthly benefits. If you have any questions about your health plan premiums, please contact your health plan(s). Information About Your Medicare Prescription Drug Plan Costs We deducted $16.00 for your Medicare prescription drug plan costs from the check you will receive for December 2016 on or about January 18, 2017. ‘This represents all Medicare prescription drug plan costs due to date. Each month, we will continue to deduct $16.00 for your Medicare prescription drug plan costs. If you have any questions about your Medicare prescription drug plan costs, please contact your Medicare prescription drug plan. c See Next Page i i i i 2 5 i