Prescription Assistance

Find out if you qualify for Medicare’s low-income subsidies or “extra help.” Subsidies can pay for some or all of your plan’s monthly premiums and the annual deductible (if there is one), as well as some or all of your drug copayments or coinsurance.

In some cases the Center for Medicare and Medicaid Services (CMS) has inaccurate information about a person’s low-income subsidy (LIS) status. This means that we might not have the correct information to determine your subsidy.

The federal Best Available Evidence (BAE) policy requires that the plan adjust your subsidy if you provide updated information that changes the level of Extra Help you receive. A memo on the CMS website explains the procedures for updating a person’s level of Extra Help.

To find out more, and to apply for extra help, call toll-free: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week, or the Social Security Office at 1-800-772-1213 between 7:00 a.m. and 7:00 p.m., Monday through Friday. TTY users should call 1-800-325-0778, or your state Medicaid office. There is no penalty to apply for extra help. If you applied last year and didn’t qualify, you can re-apply to see if you qualify this year. If you do not qualify, you are still eligible for Medicare Part D coverage, but not for extra help.

How to apply for financial help
Processing and approval of your application could take up to eight weeks, so apply early. This is an application for extra help only. Submitting this application will not enroll you in a Medicare Part D prescription drug plan.

Choose a drug plan provider
Whether or not you qualify for extra help, you also must enroll with a plan provider to get prescription drug coverage.

Get an application
The Application for Help with Medicare Prescription Drug Plan Costs is available from the Social Security Administration (form SSA-1020). You may have already received a copy in the mail. To request a copy, call toll-free: 1-800-772-1213, 7 a.m.- 7 p.m., Monday -Friday. TTY users, call: 1-877-325-0778.

Submit an application
You can mail a hard copy of your completed application or fill out and submit an online application. Mail completed paper forms to:

Social Security Administration
Wilkes-Barre Data Operations Center
P.O. Box 1020
Wilkes-Barre, PA 18767-9910

Did you qualify?
After the application is received, by mail or online, it will take up to eight weeks to find out if you have qualified for extra help.

If you do not have prescription drug coverage, you may be eligible to get the medicine you need at little or no cost. Visit The Partnership for Prescription Assistance at www.pparx.org for more information.

To see if you qualify for money-saving programs from the drug manufacturers, please visit www.NeedyMeds.org. Click below to download their brochure.

NeedyMeds Brochure

You may also contact the drug manufacturer directly to see if you are eligible for a discount.

If you need assistance paying for your NovoNordisk drugs, click here to see if you are eligible for their patient assistance program.

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