Follow the steps to successfully complete the application online.

1. Press the ‘Get Form’ button to access the Application for Extra Help With Medicare prescription drug costs and open it in your preferred editor.
2. Carefully read through the eligibility criteria outlined in the introductory information of the form, ensuring you meet the requirements before submission.
3. Begin filling out Section 1 by entering the applicant's name exactly as it appears on their Social Security card, ensuring to use one box for each letter.
4. Complete Section 2 only if applicable. If married and living with a spouse, provide their information as it appears on their Social Security card.
5. In Section 3, answer the questions regarding assets and resources, indicating whether the total worth exceeds the limits provided.
6. Move to Section 4 to list any income sources you or your spouse may have, ensuring to report totals for Social Security, pensions, and other relevant incomes.
7. Continue filling out the questions related to work history in Sections 10-14, if applicable, carefully reporting expected income and any work-related expenses.
8. Once all sections are complete, review the entire application to ensure accuracy and completeness.
9. Finally, you can save changes, download a copy for your records, and print the application if needed before submitting it through the provided pre-addressed envelope.

Start your application online today and take the first step toward securing Extra Help with your Medicare prescription drug costs.