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Disability and agingOfficial formconditional

Social Security Extra Help with Medicare prescription drug costs

Official owner Social Security Administration

Apply for drug-cost assistance throughSSA; Medicare prescription-plan enrollment is separate.

What problem this helps solve

Apply for drug-cost assistance throughSSA; Medicare prescription-plan enrollment is separate.

Who completes it: Applicant/spouse when applicable; helper completesSectionB.

What this does not prove

Some Medicare/SSI/Medicaid recipients automatically qualify and should not file this packet; confirm withSSA. Application does not enrollPartD.

Dated source check

Official destination checked

Eight-page 01-2026application packet read; recycleprior editions. Limits and eligibility are not independently calculated byNOLO.

Last checked Sep 30, 2026. A working link does not establish the current edition, suitability, agency acceptance, or service availability.

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NOLO's preparation notes summarize the dated sources in this record. Follow the agency's official instructions and current edition when they differ.

1. Check that this route fits

Stage and purpose
InitialExtraHelp request unless automatically eligible
Who completes it
Applicant/spouse when applicable; helper completesSectionB.
Jurisdiction
United States
Application mode
Online; Signed paper/mail; SSAappointment

2. Prepare before starting

  • Check automatic eligibility; gather applicant/spouse financial information.

Documents named by the source

  • Gather bank/tax/retirement/pension/VAfinancial information for answers. Paper packet says send no additional enclosures;SSArequests more if needed.
Fees and fee waivers
UNKNOWN — application fee not stated.
Account
Paper requires no account; current full online flow UNKNOWN.
Appointment
Call800-772-1213orTTY800-325-0778 to arrange assisted application.
Signature
Sign/dateSectionA including applying spouse as applicable; representative may sign if applicant cannot. Helper detailsSectionB.
Third-party certification or assessment
Unknown — confirm any certification, referral, or assessment with the official owner.

3. Follow official submission instructions

Read official instructions
  • SSAofficial onlineExtraHelp application
  • Mail signed packet alone: SSAWilkes-BarreDirectOperationsCenter,POBox1020,Wilkes-BarrePA18767-9910
  • ArrangeSSAapplication appointment

4. Get help or an accommodation

Languages: English instructions read; ask agency for language assistance.

Accessibility: PDF/web accessibility conformance not evaluated; assistance route shown.

5. Know the supported next step

  • SSA sends qualification letter; state may contact applicant aboutMSP referral unless opted out.

Restrictions and unresolved details

  • PartD enrollment is separate.
  • SSA/state determine financial eligibility.
  • Do not enclose extra documents with paper packet.

Some Medicare/SSI/Medicaid recipients automatically qualify and should not file this packet; confirm withSSA. Application does not enrollPartD.

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Return to the connected step to decide what to do next. Opening this record does not complete that step or submit an application. If the official route is unavailable, use the assistance options above or browse help in the journey.

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Form record

Adds to a private plan in this browser tab. Nothing is sent to the provider, and nothing is applied for.

Official title
Social Security Extra Help with Medicare prescription drug costs
Form number
SSA-1020B-OCR-SM
Program
Medicare PartD ExtraHelp
Jurisdiction
United States
Revision / edition
Jan 2026
Who completes it
Applicant/spouse when applicable; helper completesSectionB.
Signature
Sign/dateSectionA including applying spouse as applicable; representative may sign if applicant cannot. Helper detailsSectionB.
Submission methods
SSAofficial onlineExtraHelp application, Mail signed packet alone: SSAWilkes-BarreDirectOperationsCenter,POBox1020,Wilkes-BarrePA18767-9910, ArrangeSSAapplication appointment
Supporting documents
  • • Gather bank/tax/retirement/pension/VAfinancial information for answers. Paper packet says send no additional enclosures;SSArequests more if needed.
Languages
English instructions read; ask agency for language assistance.
Accessibility
PDF/web accessibility conformance not evaluated; assistance route shown.

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Source note: Some Medicare/SSI/Medicaid recipients automatically qualify and should not file this packet; confirm withSSA. Application does not enrollPartD.

NOLO does not process this form, receive your answers, decide eligibility, or represent the agency. A destination check does not confirm current funding, acceptance, or an outcome.

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