If you do not have Medicaid, Supplemental Security Income or a Medicare Savings Program, you can apply for help paying for your Medicare drug benefit through the Social Security Administration using either the agency's print or online application. This application can also enroll you in the Medicare Savings Program, which helps pay your Medicare costs. To be sure you get all the benefits you qualify for, complete the entire Extra Help application, even if you do not think you qualify for Extra Help.

You will also be able to apply for Extra Help at your local Medicaid Office. If you apply at your local Medicaid office, counselors there will check to see if you qualify for other assistance programs, such as a Medicare Savings Program.

To apply for Extra Help online, click on the link to the Social Security website in the LINKS Box.

You can see a sample of the Social Security Administration's print application for Extra Help by downloading the PDF file in the Related Documents box below. Do not use this sample application to apply. SSA can only process original print applications.You can call SSA to ask for an application at 800-772-1213.

For tips on applying for Extra Help for Medicare drug costs, click on the link in the Handouts box.

Local Medicaid offices will also be able to enroll you in Extra Help.

For the phone number of your local Medicaid office, click on the link in the LINKS box.

Even if you qualify for Extra Help in paying for Medicare drug costs, you must choose a private plan offering Medicare drug coverage in your area in order to get the Medicare prescription drug benefit.

If you become eligible for Extra Help, you will be given a Special Enrollment Period to enroll in a Medicare private drug plan (Part D). You will not have to pay a Part D premium penalty, even if you enroll in a Medicare private drug plan after you were first eligible. With Extra Help, you will also be able to change your Medicare drug plan once a month.

Part D Special Enrollment Periods (SEP) Chart

To find out more about the Part D premium penalty, click on the link in the GO TO box.

If your application for Extra Help is denied, or you disagree with the award, you can appeal.

You should make an appointment for a hearing with Social Security. The hearing will be conducted by phone. You can make the appointment either by

• calling Social Security at 800-772-1213; or
• mailing a request (you can get the form Social Security’s web site).

Collect any documentation you have that shows why you do qualify. Have it ready for your hearing.

To get Social Security's form to set up an appointment to appeal an Extra Help determination, click on the link in the LINKS box.