Extra Help for People with Limited Incomes: The New Medicare Prescription Drug Coverage
- Introduction
- Value of Extra Help
- Do I Qualify?
- How to Apply
- If I Don't Qualify for Extra Help
- I Already Get Government Assistance
- Answers to More Questions
- Additional Help?
- Key Words with Definitions
What If Social Security Says I Don't Qualify for Extra Help, But I Still Think I Should Get It?
You have the right to appeal the decision. Social Security will provide you with a hearing by telephone. The person who will review the decision will be someone who had no involvement in the original decision about whether or not you qualify. Social Security will review those parts of the decision that you believe are wrong and will look at any new facts you provide. Social Security may also review those parts that you believe are correct.
To request an appeal, call Social Security toll-free at 1-800-772-1213. (When calling, you should repeatedly press the "#" key to bypass the recorded messages and speak to someone in person.) If you want to file an appeal, remember the following:
- You have 60 days to ask for an appeal.
- The 60 days start the day after you receive a letter from Social Security saying you are not eligible. Social Security will assume you got the letter 5 days after the date on the letter unless you show them that you didn't get it within the 5-day period.
- You can have a lawyer, friend, or someone else help you. Your local Social Security office has a list of groups that can help you with your appeal. To find your local Social Security office, call 1-800-772-1213.
What if I still don't qualify for Extra Help?
You can still enroll in a Medicare drug plan to get the drug coverage, even while the decision about Extra Help is being appealed. To learn more about Medicare's standard coverage and how to choose a drug plan, see AARP's free educational guide, Medicare Prescription Drug Coverage: What You Need to Know About... You can also call Medicare at 1-800-MEDICARE (1-800-633-4227; or TTY 1-877-486-2048).
What else can I do if I don't qualify?
You may also be eligible for your state pharmacy assistance program, if your state has one. To find out if you are eligible, call your local State Health Insurance Assistance Program (SHIP). You can find a local SHIP phone number by calling 1-800-677-1116 or by going to their website. You can also go to www.aarp.org/quicklink and click on the Benefits QuickLink tool to see if you might be eligible for other programs.
