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20202021 PLAN YEARCashinLieu Form & Medical Benefit Advergame: Social Security Number: Employee Acknowledgement: This form acknowledges that I have been offered, and have elected to voluntarily waive,
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How to fill out extra help with medicare

01
To fill out extra help with Medicare, follow these steps:
02
Gather your personal information such as your Social Security number, date of birth, and contact information.
03
Determine if you are eligible for extra help. Extra help is available for individuals with limited income and resources.
04
Visit the Social Security Administration's website or call their toll-free number to begin the application process.
05
Complete the application form by providing accurate information about your income, assets, and current prescription drug coverage.
06
Review your application for any errors and make sure all required fields are filled out.
07
Submit the application online or by mail as instructed by the Social Security Administration.
08
Wait for a response from the Social Security Administration regarding your eligibility for extra help.
09
If approved, you will receive information about your extra help benefits and how to utilize them.
10
If denied, you may have the option to appeal the decision or seek other assistance programs.
11
Keep a copy of your application and any correspondence for your records.

Who needs extra help with medicare?

01
Extra help with Medicare is intended for individuals who have limited income and resources.
02
Specifically, it is designed to assist those who struggle to pay for their prescription drugs and Medicare Part D premiums.
03
This assistance program is beneficial for individuals who have a low income, limited savings, or receive assistance from programs such as Medicaid or Supplemental Security Income (SSI).
04
Additionally, individuals who lack prescription drug coverage or have high prescription drug costs may also qualify for extra help with Medicare.
05
It is recommended to check the eligibility criteria and requirements outlined by the Social Security Administration or consult with a healthcare professional to determine if you qualify for extra help.
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