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  • Ssa-1020b-ocr-sm-inst 2014

Get Ssa-1020b-ocr-sm-inst 2014-2025

The SHIP offers help with your Medicare questions. Please mail your application today. Carolyn W. Colvin Acting Commissioner Form SSA-1020B-OCR-SM-INST 01-2013 Recycle prior editions General Instructions for Completing the Application for Extra Help with Medicare If You Are Assisting Someone Else With This Application Answer the questions as if that person were completing the application. You must know that person s Do you have Medicare and Supplemental Security Income SSI or Medicare and Medicaid If the answer is YES do not complete this application because you automatically will get the Extra Help. Does your State Medicaid program pay your Medicare premiums because you belong to a Extra Help automatically and may not need to complete this application. How To Complete This Application Use BLACK INK only Keep your numbers letters and inside the boxes use only CAPITAL letters Do not add any handwritten comments on the application Do not use dollar signs when entering money amounts and C....

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How to fill out the SSA-1020B-OCR-SM-INST online

The SSA-1020B-OCR-SM-INST form is essential for individuals seeking Extra Help with Medicare prescription drug plan costs. This guide provides a step-by-step approach to filling out the form online, ensuring clarity and ease of understanding for all users.

Follow the steps to complete the SSA-1020B-OCR-SM-INST online successfully.

  1. Click the ‘Get Form’ button to access the form and open it in the online editor.
  2. Fill in the applicant’s name as it appears on their Social Security card, ensuring to use one box for each letter. Provide the applicant's Social Security number and date of birth in the designated fields.
  3. If applicable, enter the spouse's name, Social Security number, and date of birth. If not married or not living together, skip this step.
  4. Answer the question regarding savings and assets, marking 'YES' or 'NO' as appropriate for eligibility beyond the limits stated.
  5. For those answering 'NO' or 'NOT SURE', proceed to declare the value of all bank accounts, investments, and available cash. If none exist, mark the 'NONE' box.
  6. Indicate any other financial sources contributing to income, detailing the monthly amounts received and placing an 'X' in the 'NONE' box if not applicable.
  7. Complete each subsequent question by providing accurate financial details, ensuring to read instructions carefully for each regarding income and assets.
  8. Sign and date the application, providing contact information. If someone assisted in filling out the form, ensure to complete Section B with their details.
  9. Review all provided information for accuracy. Once confirmed, you can save your changes, download, print, or share the completed form as required.

Start filling out your SSA-1020B-OCR-SM-INST online today to ensure you receive the financial help you may need.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232