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The client letter must be placed in a plain, unsealed, unstamped envelope with the client's full name and social security number written legibly on the front of the envelope.
Form SSA-1021 (04-2021) Appeal of Determination for. Extra Help with Medicare. Prescription Drug Plan Costs.
Procedure -- Wilkes-Barre Direct Operations Center (WBDOC) Processing. The WBDOC reviews and processes most scannable CDR mailer forms.
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Form SSA-1020B-OCR-SM-INST (01-2014) Recycle prior editions. Social Security Administration. Important Information. You may be eligible to get Extra Help paying for your prescription drugs. The Medicare prescription drug program gives you a choice of prescription plans that offer various types of coverage.

irs form 1021