Whitesburg KY
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Medicare drug plan



Question: How do I obtain a copy of the form, Application for Help with Medicare Prescription Drug Plan Costs?

Answer: If you wish to apply for Extra Help with Medicare prescription drug plan costs, we recommend you use our online application at www.socialsecurity. gov/i1020/. Meanwhile, you can view a sample at www.socialsecurity.gov/prescriptionhelp. There, you also can find instruction sheets in 15 different languages to help you understand the English application. Soon, the online application also will be available in Spanish.

If you prefer not to fill out this application on the Internet, you can call our toll-free number, 1- 800- 772- 1213, to ask for a paper application. Also, you can make an appointment at your local Social Security office to apply for Extra Help with Medicare prescription drug plan costs. If you are deaf or hard of hearing, call our toll-free TTY number, 1- 800- 325- 0778. Representatives are available Monday through Friday from 7 a.m. to 7 p.m.



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