Form H1200-EZ: Application for Assistance - Aged and Disabled

Form H1200-EZ PDF Details

To find out if you are eligible for reducing your expenses for the drug coverage, you may apply through the Social Security Administration.

Proof: please include with your application proof of all income and things that you own; do not send originals.

Answers: it is important that you answer each question; be sure that the application is signed and dated.

Interview: an interview is not required as part of the application process.

Questions: call 2-1-1 with any questions about the application.