Application for Extra Help With Medicare Prescription Drug Plan Costs (field office interview)

Application for Help with Medicare Prescription Drug Plan Costs

SSA-1026 MAPS MEDQ - Revised Screenshots

Application for Extra Help With Medicare Prescription Drug Plan Costs (field office interview)

OMB: 0960-0696

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Revised Screens

Justification for Non-Substantive Change to


Form SSA-1020/i1020

Application for Extra Help with Medicare Prescription Drug Plan Costs


OMB No. 0960-0696



Change 1:



Revised MEDQ Default Screen (QDIS)


Shape12 Shape11 Shape13 Shape15 Shape14 Shape10 Shape9 Shape8 Shape4 Shape7 Shape6 Shape5 Shape3 Shape1 Shape2

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Revised QDIS display: Client Data section (Part A tab)


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Revised QDIS display: Client Data section (Part B tab)


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Revised QDIS display: Client Data section (Part C tab)


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Revised QDIS display: Applicant Data section (Part D & ‘All’ tab)


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Revised QDIS display: Spouse Data section (Part D & ‘All’ tab)


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Shape60



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorNetherton, Linnet
File Modified0000-00-00
File Created2021-01-15

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