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UHC Preferred Dual Complete FLV2 (HMO DSP) H1045064000Information about you (Please type or print in black or blue ink)
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What is extra help from Medicare?
Extra Help from Medicare is a program that helps individuals pay for prescription drug costs, such as premiums, deductibles, and co-payments for Medicare Part D.
Who is required to file extra help from Medicare?
Individuals with limited resources and income, including those who are enrolled in Medicare and meet the eligibility criteria set by the Social Security Administration, are required to file for Extra Help from Medicare.
How to fill out extra help from Medicare?
To fill out the application for Extra Help from Medicare, beneficiaries can complete the application online at the Social Security Administration's website, or they can fill out a paper application and submit it by mail.
What is the purpose of extra help from Medicare?
The purpose of Extra Help from Medicare is to assist eligible individuals with low income and resources in affording their prescription drugs under Medicare Part D, thus reducing their out-of-pocket costs.
What information must be reported on extra help from Medicare?
Applicants must report information such as their income, resources, medical expenses, and any current prescription drug coverage they may have.
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