Prescription Drug Assistance
Great Lakes Program
600 West Madison
Date: November 1, 2005
Social Security Number:
JOHN Q. PUBLIC
123 MAIN ST
SPRINGFIELD OH 45501
On October 25, 2005, you submitted an Application for Help with Medicare Prescription Drug Plan Costs. Because you receive Supplemental Security Income,
you are automatically eligible for extra help with Medicare prescription drug plan
costs. We do not need to process your application.
If You Have Any Questions
For information about Medicare prescription drug plans or other Medicare issues, visit
www.medicare.gov on the Internet or call toll-free 1-800-MEDICARE (1-800-633-4227). If you are deaf
or hard of hearing, you may call the Medicare TTY number toll-free at 1-877-486-2048.
For information about the extra help with the costs related to Medicare prescription
drug plans or general information about Social Security, visit our website at www.socialsecurity.gov on the Internet. You may also call Social Security toll-free at 1-800-772-1213. If
you are deaf or hard of hearing, you may call our TTY number toll-free at 1-800-325-0778.
We can answer most questions by phone.
If you do call, please have this letter with you. It will help us answer your questions.