Under
$16,335 (Single)
$22,065 (Couple)

(Partial)

Under
$13,070 (Single)
$26,120(Couple)

$63 Deductible
Drug co-payments: 15 percent or less
Sliding scale assistance toward the monthly premium

APPLY through Social Security
1-800-772-1213 or www.ssa.gov
May also be eligible for SLMB II (see chart below). 
Call SHIP for an application 410-887-2059 or the Local Department of Social Services (DSS)
APPLY to Maryland Senior Prescription Drug Assistance Program (SPDAP) 1-800-551-5995

Under
$14,701 (Single)
$19,858 (Couple)

(Full)

Under
$13,070 (Single)
$26,120 (Couple)

No Monthly Premium
No Deductible
$2.60 generic drug $6.50 brand name drug

APPLY through Social Security
1-800-772-1213 or www.ssa.gov
May also be eligible for QMB/SLMB (see chart below)
Call SHIP for application 410-887-2059 or the Local DSS

Under
$10,890 (Single) 
$14,710 (Couple)

(Full)

Under
$8,440 (Single)
$13,410 (Couple)

No Premium
No Deductible
$1.10 generic
$3.30 name brand

APPLY through Social Security 
1-800-772-1213 or www.ssa.gov
May also be eligible for the QMB/SLMB (See chart below).
Call SHIP for application 410-887-2059 or the Local DSS

 Assets:  House and car not counted as assets/resources. Couple is defined as married and living together.
*2012 Benchmark $34.57. No premium for Full Extra Help if premium below benchmark.

Under
$32,670 (Single)
$44,130(Couple**)

Not Counted                   

Up to $35 toward the monthly premium AND in some plans pays 5 percent in the donut hole 

APPLY through Maryland Senior Prescription Drug Assistance Program (SPDAP)
1-800-551-5995
www.marylandspdap.com