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  • Ssa-1020b-ocr-sm-inst 2014

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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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© 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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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