Whether you qualify for Extra Help or not, you must enroll for prescription drug coverage in order to apply for Extra Help.
Step 2: Complete an application for Extra Help.
The easiest way to apply is to download an application and submit it online. You can also fill out a paper copy. If you haven’t already received a copy of the application by mail, request one toll-free at 1-800-772-1213, 7 a.m. to 7 p.m., Monday through Friday. TTY: 1-877-325-0778.
Mail completed applications to:
Social Security Administration
Wilkes-Barre Data Operations Center
P.O. Box 1020
Wilkes-Barre, PA 18767-9910
After submitting your application, you’ll hear within 8 weeks if you qualify for Extra Help with Part D costs.
If you meet any one of the criteria below, you will automatically receive Extra Help from Medicare to help with your Part D costs. There's no need to apply.
You receive both Medicare and Medicaid.
You receive both Supplemental Security Income (SSI) benefits and have Medicare.
If you aren't getting Extra Help, you can see if you qualify by calling:
1-800-Medicare (toll-free; TTY/TDD users call 1-877-486-2048), 24 hours a day/7 days a week,
Your State Medicaid Office, or
The Social Security Administration toll-free at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.
If you have any questions, please contact UnitedHealthcare Customer Service.
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.
A State Pharmaceutical Assistance Program (SPAP) provides state-funded prescription drug assistance to people who need help paying for their monthly prescription drug plan premiums, deductibles, copays and coinsurance.
For most programs, members must meet specific income guidelines and additional requirements that vary by state.