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Medicare Rx Extra Help Application

Preparing To Use This Application

What information will you need?

To find out if you could be eligible for Extra Help with Medicare prescription drug costs, Social Security needs information about your (and your spouse’s, if you are married and living together) income and resources. Documents that may help you prepare include:

  • Social Security card;
  • bank account statements, including checking, savings, and certificates of deposit (CDs);
  • Individual Retirement Accounts (IRAs), stocks, bonds, savings bonds, mutual funds, other investment statements;
  • tax returns;
  • payroll slips; and
  • your most recent Social Security benefits award letters or statements for Railroad Retirement benefits, Veterans benefits, pensions and annuities.

If you do not have these documents, provide us with your best estimate so that Social Security can tell you whether you are likely to qualify for Extra Help with your Medicare prescription drug costs. You need this information only to help you complete the application. You should not have to submit the documents unless someone from Social Security contacts you.

Can you edit your information?

When you have completed the application, you will get a full summary of the information you entered. You can make changes if necessary before you submit your application. After you submit the application electronically, you will be able to print or save a receipt for your submitted application.

How long can you work on each page?

For security reasons, there are time limits on each page. After 45 minutes on a page, you must go to another page or your application session will end, and your work will be lost.

If you are unsure about how to use this online application, you can find more details on the following pages: