What You Need To Complete The Application For Help With Medicare Prescription Drug Plan Costs

Social Security and the Centers for Medicare & Medicaid Services are working together to get you extra help with your prescription drug costs. To determine if you could be eligible for this extra help, Social Security will need to know your income and the value of your savings, investments and real estate (other than your home). To qualify for extra help:

• Your annual income must be limited to $15,600 for an individual ($21,000 for a married couple living together).
  
  
• Even if your annual income is higher, you still may be able to get some help with your monthly premiums, annual deductibles and prescription co-payments. Some examples where your income may be higher include if you or your spouse:

  —Support other family members who live with you;

  —Have earnings from work; or

  —Live in Alaska or Hawaii; and

• Your resources must be limited to $11,990 for an individual ($23,970 for a married couple living together). Resources include such things as bank accounts, stocks and bonds. We do not count your house and car as resources.
  

What you need to know

Identify the things you own by yourself, with your spouse or with someone else, but do not include your home, vehicles, burial plots or personal possessions.

Review all your income.

Gather your records in advance to save time.

Remember that this worksheet is not an application. This worksheet can assist you in completing the actual application for extra help.

Documents that will help you prepare in advance include:

• Statements that show your account balances at banks, credit unions or other financial institutions;

• Investment statements;

• Life insurance policy statements;

• Stock certificates;

• Tax returns;

• Pension award letters; and

• Payroll slips.

How you can get more information

For more information about getting extra help with your Medicare prescription drug costs visit www.socialsecurity.gov or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

You can apply online for extra help. To apply by phone or get an application, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for the Application for Help with Medicare Prescription Drug Plan Costs (SSA-1020). Social Security representatives are available to help you complete your application.

To learn more about the Medicare prescription drug plans and special enrollment periods visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Medicare also can tell you about agencies in your area to help you with Medicare prescription drug plans.