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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 is estimated to be worth an average of $3,900 per year.
What you will find here:
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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
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An online tool
to help people decide if they qualify for help with Medicare prescription
drug costs.
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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)
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Booklet - Understanding The Extra Help With Your Medicare Prescription Drug Plan, Publication No. 05-10508, (04/09) (English and Spanish PDF)
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Leaflet - In times like these, every dollar counts. Save an average of $3,900., Publication No. 05-10509, (05/09) (English and Spanish PDF)
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Fact sheet - Help someone save an average of $3,900 on prescription drug costs, Publication No.
05-10505, (02/09) (English and Spanish PDF)
- Fact sheet - Tips For Completing The Application For Help With Medicare Prescription Drug Plan Costs, Publication
No. 05-10122, (02/09) (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, (02/09) (English and Spanish PDF)
- Fact sheet -What You Need To Complete The Application
For Help With Medicare Prescription Drug Plan Costs,
Publication No. 05-10128, (02/09) (English and Spanish PDF)
- 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, (02/09) (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, (02/09) (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)
- 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
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What's New |
Help us find Medicare beneficiaries who might qualify for extra
help with their Medicare prescription drug plan costs. We are asking
family members, caregivers and third parties to help anyone who
might qualify apply for the extra help. If you know a Medicare
beneficiary who might qualify or if you think you might qualify
yourself, visit our electronic leaflet for
more information.
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Additional Resources |
You may qualify for other programs to help you purchase your prescriptions. Below, are additional web sites with calculators and other tools designed to help you make informed decisions when it comes to managing your prescription drug costs. |
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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.
You can call 1-800-MEDICARE (1-800-633-4227) to speak to a Medicare Customer Service Representative. TTY users should call 1-877-486-2048.
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