2675.2 Determined Eligibles

Both KDHE-DHCF and the Social Security Administration share responsibility for determining subsidy eligibility for all other applicants. While the Medicare beneficiary may apply with the entity of their choice to determine eligibility, an individual seeking subsidy coverage at KDHE-DHCF shall be directed to Social Security to file an application. However, eligibility staff may assist the individual in completing the SSA-1020 subsidy application form. The form should then be date stamped and mailed to the SSA processing center at:

Social Security Administration

Wilkes-Barre Data Operations Center

P.O. Box 1020

Wilkes-Barre, PA 18767-9910

Social Security will process the application and notify the applicant of the subsidy eligibility determination. An individual who has already applied for subsidy coverage with SSA should wait for that determination to be completed. However, the individual may file another SSA-1020 subsidy application with KDHE-DHCF while the original SSA application is still pending. The application shall be accepted, date stamped, and forwarded to SSA for processing.