You May Have More Help Available Than You Realize.

Answer a few questions and we’ll look for federal, state and local programs that may be worth checking.

We do not need your Social Security number, Medicare number, bank account number or other account credentials.

About You

AgeStateZIP codeHousehold size

What is your household's total gross monthly income?

Gross income means income before taxes, insurance premiums or other deductions.

What Income Is Included in That Amount?

Check all that apply.

Wages or salarySelf-employment incomeSocial Security retirementSocial Security Disability (SSDI)SSIPensionUnemploymentState disability paymentsRetirement account withdrawalsRental incomeOther income

What Are You Having Trouble Paying For?

Check all that apply.

PrescriptionsMedical bills or healthcare costsMedicare premiums or copaysFoodElectricity, gas or waterRent or mortgageProperty taxesTransportationHelp at home or caregivingDental careHearing aidsVision carePhone or internetOther everyday expenses

Medicare & Medicaid

I have Medicare

Medi-Cal status

Disability & Help at Home

A health condition or disability prevents or substantially limits my ability to workI need help with daily activities at homeSomeone needs supervision to stay safe because of memory loss, confusion, developmental disability or another conditionI am an unpaid caregiverSomeone in my household has a medical condition or medical equipment that requires extra electricity, heating or cooling

Housing & Veterans

I own my home

Veteran connection

Michelle Heberling • Medicare • Retirement Planning • Caregiving Guidance

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