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Extra Help with Medicare Prescription Drug Plan Costs | |
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Extra Help Forms and Publications(Aquí en Español) |
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Forms and Notices |
Instructions on how to complete the Extra Help application (SSA-1020)Instructions for the Application
for Extra Help with Medicare Prescription Drug Plan Costs,
(SSA-1020-INST). Also available in Arabic, Armenian, Chinese, Español,
Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Tagalog, and Vietnamese. The
instructions are only guidelines and not to be used as applications.
Apply for Extra Help online (SSA-i1020)You can apply
for Extra Help online (available in English only) or you
can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to
apply over the phone or to request a paper application (paper applications
are available in English and Español), or you can apply at your local
Social Security office.
Appeal the determination for Extra Help (SSA-1021)Appeal
of Determination for Extra Help with Medicare Prescription Drug Plan
Costs,
(SSA-1021). To appeal the decision we made about your eligibility
for Extra Help with Medicare prescription drug plan costs. (English and Español PDF)
Extra Help review form (SSA-1026B)Social Security Administration Review of Your Eligibility for Extra Help, (SSA-1026B). To review your continuing eligibility for Extra Help with Medicare prescription drug plan costs. (English and Español PDF)
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Last reviewed or modified Friday Nov 20, 2009 |
