Welcome!
Medicare’s Prescription Drug Coverage (also known as Part D) offers
extra help with prescription drug costs for people with Medicare who
have limited incomes and resources. Depending on your income and
resources, you may be able to get help paying for premiums, annual
deductible, and co-payments related to the Medicare Prescription Drug
Coverage - an average of $2,100 per year in extra help.
What Is This Application?
It is an application for extra help with Medicare prescription drug costs. It is not an application for coverage under a Medicare prescription drug plan.
You will have to enroll directly with an approved Medicare prescription
drug plan in order to get this coverage. If you need information about
the Medicare Prescription Drug Coverage, call Medicare's toll-free
number 1-800-MEDICARE (1-800-633-4227) or visit
www.medicare.gov. If you are deaf or hard of hearing, you may call the
Medicare TTY number toll-free at 1-877-486-2048.
Who Should Complete This Application For Extra Help With Costs under the Medicare Prescription Drug Coverage?
You should complete this application for extra help if:
- You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Supplementary Medical Insurance), and
- You live in one of the 50 states or the District of Columbia, and
- Your savings, investments, and real estate (other than your home)
are not worth more than $11,500, if you are single, or $23,000 if you
are married and living with your spouse. Depending on your situation,
you still may be eligible for this extra help, even if you have more
than those amounts.
Who Should Not Complete This Application For Extra Help With The Medicare Prescription Drug Plan Costs?
You should not complete this application if:
- You receive Medicaid with prescription drug coverage and have Medicare, or
- Your state pays for your Medicare premiums (Medicare Savings Program), or
- You receive Supplemental Security Income (SSI) payments and have Medicare.
If you are in one of the 3 groups above, you are automatically eligible for the extra help and do not need to apply for it.
How Can You Get The Extra Help?
To get extra help with prescription drug costs, you must complete and submit this application.
The Social Security Administration (SSA) will review your application
and send you a letter to let you know if you qualify for the extra
help. SSA also will send you information about the Medicare
Prescription Drug Coverage and tell you what you should do next.
When can you Submit Your Application?
Social Security makes this service available during the following hours (Eastern Time):
Monday through Friday: 5:00 AM - 1:00 AM
Saturday: 5:00 AM - 11:00 PM
Sunday: 8:00 AM - 10:00 PM
Holidays: 5:00 AM - 11:00 PM
* To make sure you have sufficient time, we recommend that you begin
at least one hour before applications can no longer be submitted.
If you need help completing this application, Click here to contact an Access to Benefits Coalition, or call Social Security toll-free at 1-800-772-1213. If you are deaf or hard of hearing, call Social Security’s toll-free TTY number at 1-800-325-0778.
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