Information for Organizations

Medicare beneficiaries are eligible for the extra help if they have limited income and resources. The extra help can increase their cost savings by paying for part of the monthly premiums, annual deductibles and prescription co-payments under the new prescription drug program. The extra help could be worth up to $3,600 per year.

What you will find here:

• An online application for help with Medicare prescription drug costs.
  
  Note:If you’re helping someone file an application, or you’re filing for yourself, submit an Internet application to us right away to avoid delaying the extra help
  

• An online tool to help people decide if they qualify for help with Medicare prescription drug costs.

• Sample: Application for Help with Medicare Prescription Drug Plan Costs, SSA-1020. Instruction sheets are available in 15 different languages to help you understand the English application. The instructions are to be used as guides and cannot be used as applications. Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, Vietnamese

  The actual applications are available only in English and Spanish. You must complete either an English or Spanish scannable paper application or you can apply online (English only).

• SSA-1021: Form to appeal the decision we made about your eligibility for help with Medicare prescription drug plan costs.

• SSA-1026:Form to review your continuing eligibility for extra help with Medicare Prescription Drug plan costs. (English and Spanish PDF)
  
  
• Booklet - Understanding The Extra Help With Your Medicare Prescription Drug Plan,. Publication No. 05-10508, (02/08) (English and Spanish PDF)
  
  
• Leaflet - Save on drug costs! Apply for extra help with Medicare prescription drug plan costs, Publication No. 05-10509, (08/08) (English and Spanish PDF)
  
  
• Fact sheet- Help someone save up to $3,600 on prescription drug costs, Publication No. 05-10505, (08/08) (English, Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese PDF)
  
  

• Tips For Completing The Application For Help With Medicare Prescription Drug Plan Costs, Publication No. 05-10122, (02/08) (English and Spanish PDF)
  
  
• Fact sheet - Review Of Your Eligibility For Extra Help With Medicare Prescription Drug Plan Costs: Some Things You Should Know, Publication No. 05-10111, (08/07) (English, Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese PDF)
  
  
• Fact sheet -Getting Help With Medicare Prescription Drug Plan Costs, Life Insurance: Face And Cash Values, Publication No. 05-10108, (03/06) (English, Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese PDF) (Alternative Formats)
  
  
• Fact sheet -Getting Help With Medicare Prescription Drug Plan Costs, Income And Resource Limits, Publication No. 05-10115, (06/08) (English, Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese PDF)
  
  
• Fact sheet -What You Need To Complete The Application For Help With Medicare Prescription Drug Plan Costs, Publication No. 05-10128, (06/08) (English, Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese PDF) (Alternative Formats)
  
  
• Fact sheet -Getting Help With Medicare Prescription Drug Plan Costs, Information For State And County Legislators, Publication No. 05-10012, (03/06) (English and Spanish PDF)
  
  
• Fact sheet -Getting Help With Medicare Prescription Drug Plan Costs, Information For American Indians And Alaska Natives, Publication No. 05-10013, (02/08) (English PDF)
  
  
• Fact sheet -Getting Help With Medicare Prescription Drug Plan Costs, When Someone Pays Your Household Expenses, Publication No. 05-10094, (03/06) (English and Spanish PDF)
  
  
• Fact sheet -Getting Help With Medicare Prescription Drug Plan Costs, Information For Medicare Beneficiaries With Disabilities Publication No. 05-10118, (02/08) (English and Spanish PDF)
  
  
• Fact sheet-Your Right To Question The Decision On Your Application For Help With Medicare Prescription Drug Plan Costs, Publication No. 05-10144, (01/06) (English and Spanish PDF)
  
  
• Fact Sheet-What You Should Know About The Medicare Prescription Drug Plans: Qualify For Extra Help And Pay No Penalty In 2008,Publication No. 05-10126 (02/08) (English and Spanish PDF)
  
  
• Medicare Outreach Posters
  
  
• Medicare Posters in other languages (8.5" x 11" PDF format). Download and print: Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Spanish2, Tagalog, Vietnamese
  
  

The Official U.S. Government Site for People with Medicare

Although Social Security determines entitlement to Medicare benefits, the Medicare program is administered by a different agency, the Centers for Medicare & Medicaid Services (CMS). There also is a Medicare Web site, and CMS has several publications about Medicare prescription drug coverage.

For information about changes in your extra help coverage, visit CMS at http://www.cms.hhs.gov/limitedincomeandresources/. On this site, you also will find copies of CMS mailings.