Who Should Complete This Application For Extra Help With Medicare Prescription Drug Plan Costs?

You should complete this application for Extra Help on the Internet if:

– You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance); and

– You live in one of the 50 States or the District of Columbia; and

– Your combined savings, investments, and real estate are not worth more than $28,150, if you are married and living with your spouse, or $14,100 if you are not currently married or not living with your spouse. (Do NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.) If you have more than those amounts, you may not qualify for the extra help. However, you can still enroll in an approved Medicare prescription drug plan for coverage.