Application for Help with Medicare Prescription Drug Plan Costs

ICR 202102-0960-001

OMB: 0960-0696

Federal Form Document

Forms and Documents
ICR Details
0960-0696 202102-0960-001
Received in OIRA 201902-0960-001
SSA
Application for Help with Medicare Prescription Drug Plan Costs
Revision of a currently approved collection   No
Regular 06/03/2021
  Requested Previously Approved
36 Months From Approved 06/30/2021
900,580 986,551
419,801 464,389
0 0

The Medicare Modernization Act of 2003 mandated the creation of the Medicare Part D prescription drug coverage program and provided for certain subsidies for eligible Medicare beneficiaries to help pay for the costs of prescription drugs. SSA uses Form SSA-1020 (and the i1020, its electronic counterpart), the Application for Extra Help with Medicare Prescription Drug Plan Costs, to collect information to make Part D subsidy eligibility determinations. The respondents are Medicare beneficiaries or applicants applying for Part D low income subsidy.

US Code: 42 USC 1395w-101 Name of Law: Social Security Act
   PL: Pub.L. 110 - 275 100 Name of Law: Medicare Improvements for Patients and Providers Act of 2008
  
PL: Pub.L. 110 - 275 100 Name of Law: Medicare Improvements for Patients and Providers Act of 2008

Not associated with rulemaking

  86 FR 12068 03/01/2021
86 FR 29348 06/01/2021
No

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 900,580 986,551 0 0 -85,971 0
Annual Time Burden (Hours) 419,801 464,389 0 0 -44,588 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
When we last cleared this IC in 2018, the burden was 464,389 hours. However, we are currently reporting a burden of 419,801 hours. This change stems from a decrease in the number of responses from Medicare beneficiaries applying for Extra Help from 986,551 to 900,580. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data.

$11,165,559
No
    Yes
    Yes
No
No
No
No
Faye Lipsky 410 965-8783 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/03/2021


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