ô±Ýã ä»ïù àõÝ»ù Ø¿ïÇù¿ñÇ  ̧»Õ3·Çñáí

 ̧»Õáñ3Ûù ¶Ý»Éáõ Ìñ3·ñÇ Ì3Ëë»ñÁ Ðá·3Éáõ

 ̧ÇÙáõÙÝ3·ÇñÁ 2ÙμáÕç3óÝ»Éáõ Ð3Ù3ñ

êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛ3Ý ì3ñãáõÃÛáõÝÁ »õ Ø¿ïÇù¿ñÇ áõ Ø¿ïÇù¿»1Ç Ì3é3ÛáõÃÛ3Ý 

Î»ÝïñáÝÁ Ñ3Ù3ï»Õ 3ßË3ïáõÙ »Ý Ó»1⁄2 

ïñ3Ù31ñ»Éáõ Ñ3í»ÉÛ3É û·ÝáõÃÛáõÝ Ó»ñ 1»Õ3·Çñáí 

·Ý»ÉÇù 1»Õ»ñÇ Í3Ëë»ñáõ Ñ3Ù3ñ: àñå¿ë1⁄2Ç 

áñáß»Ýù Ó»ñ Çñ3í3ëáõÃÛáõÝÁ 3Ûë Ñ3í»ÉÛ3É 

û·ÝáõÃÛ3Ý, êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛáõÝÁ 

å»ïù ¿ ÇÙ3Ý3 Ó»ñ »Ï3ÙáõïÇ »õ 1ñ3Ù3Ï3Ý 

ÙÇçáóÝ»ñÇ ã3÷Á, ûñÇÝ3Ïa Ó»ñ ËÝ3ÛáÕáõÃÛáõÝÝ»ñÇ, 

Ý»ñ1ñáõÙÝ»ñÇ »õ 3Ýß3ñÅ Ï3Éí3ÍÇ 3ñÅ»ùÁ 

(μ3óÇ Ó»ñ ïÝÇó):  ̧áõù Ï3ñáÕ »ù Çñ3í3ëáõ ÉÇÝ»É 

Ñ3í»ÉÛ3É û·ÝáõÃÛ3Ý, »Ã» áõÝ»ù.

• ê3ÑÙ3Ý3÷3Ï »Ï3Ùáõï (14,700 1áÉ3ñÇó ó3Íña 

ÙÇ 3ÝÑ3ïÇ Ñ3Ù3ñ Ï3Ù 19,800 1áÉ3ñÇó ó3Íña 

ÙÇ3ï»Õ 3åñáÕ 3ÙáõëÝ3ó3Í 1⁄2áõÛ·Ç Ñ3Ù3ñ): 

ÜáõÛÝÇëÏ »Ã» Ó»ñ ï3ñ»Ï3Ý »Ï3ÙáõïÁ 3í»ÉÇ 

μ3ñÓñ ¿, Ï3ñ»ÉÇ ¿ ëï3Ý3ù áñáß3ÏÇ û·ÝáõÃÛáõÝ 

Ó»ñ 3Ùë3Ï3Ý ß3Ñ3μ3ÅÝÇ (premiums), Ó»ñ 

ï3ñ»Ï3Ý å3ñïùÇ μ3ÅÝÇ (deductible) »õ 

1»Õ3·ÇñÇ Ó»ñ μ3ÅÝÇ Í3Ëë»ñáõ (co payment) 

Ñ3Ù3ñ: Ò»ñ »Ï3ÙáõïÁ Ï3ñáÕ ¿ 3í»ÉÇ μ3ñÓñ 

ÉÇÝÇ »Ã» 1áõù Ï3Ù Ó»ñ

ÏÇÝÁ (3ÙáõëÇÝÁ).

—ú·ÝáõÙ »ù Ó»1⁄2 Ñ»ï 3åñáÕ ÁÝï3ÝÇùÇ 3ÛÉ 

3Ý13ÙÝ»ñÇÝ.

—àõÝ»ù Ñ3ëáõÛÃ 3ßË3ï3ÝùÇó.

—2åñáõÙ »ù 2É3ëÏ3ÛáõÙ Ï3Ù Ð3í3Û3Ý 

ÏÕ1⁄2ÇÝ»ñáõÙ, ÇÝãå»ë Ý3»õ

• ê3ÑÙ3Ý3÷3Ï 1ñ3Ù3Ï3Ý ÙÇçáóÝ»ñ 

(10,000 1áÉ3ña ÙÇ 3ÝÑ3ïÇ Ñ3Ù3ñ Ï3Ù 

20,000 1áÉ3ña ÙÇ3ï»Õ 3åñáÕ 3ÙáõëÝ3ó3Í 

1⁄2áõÛ·Ç Ñ3Ù3ñ): ØÇçáóÝ»ñÇ 3Ûë ë3ÑÙ3Ý3ÛÇÝ 

ã3÷Á Ï3ñáÕ ¿ ÉÇÝÇ 1,500 1áÉ3ñ 3í»ÉÇ 

(Ûáõñ3ù3ÝãÛáõñ 3ÝÓÇ Ñ3Ù3ñ), »Ã» 1áõù Ó»ñ 

·áõÙ3ñÇ ÙÇ Ù3ëÁ û·ï3·áñÍ»Éáõ »ù Ã3ÕÙ3Ý 

Í3Ëë»ñÇ Ñ3Ù3ñ:

ô±Ýã å»ïù ¿ ÇÙ3Ý3ù

Üß»°ù 3ÛÝ ÇÝãù»ñÁ, áñáÝó 1áõù ïÇñ3å»ïáõÙ »ù 

3é3ÝÓÇÝ, Ó»ñ ÏÝáç (3ÙáõëÝáõ) Ï3Ù 3ÛÉ 3ÝÓÇ Ñ»ï, 

ë3Ï3ÛÝ ÙÇ° ÁÝ1·ñÏ»ù Ó»ñ ïáõÝÁ, ÇÝùÝ3ß3ñÅÝ»ñÁ, 

·»ñ»1⁄2Ù3Ý3ï»Õ»ñÁ Ï3Ù 3ÝÓÝ3Ï3Ý 

ë»÷3Ï3ÝáõÃÛáõÝÝ»ñÁ:

êïáõ·»°ù Ó»ñ 3ÙμáÕç »Ï3ÙáõïÁ:

Ð3í3ù»°ù Ó»ñ ï»Õ»ÏáõÃÛáõÝÝ»ñÁ Ý3Ëûñáùa 

Å3Ù3Ý3Ï ËÝ3Û»Éáõ Ýå3ï3Ïáí:

ÐÇß»°ù, áñ 3Ûë 3ßË3ï3Ýù3ÛÇÝ 3ÕÛáõë3ÏÁ 

ÇÝùÝÇÝ 1ÇÙáõÙÝ3·Çñ ã»: 2Ûë 3ßË3ï3Ýù3ÛÇÝ 

3ÕÛáõë3ÏÁ û·ÝáõÙ ¿ Ó»1⁄2 Éñ3óÝ»Éáõ ÇëÏ3Ï3Ý 

1ÇÙáõÙÝ3·ÇñÁ Ñ3í»ÉÛ3É û·ÝáõÃÛáõÝ

ëï3Ý3Éáõ Ñ3Ù3ñ:

ö3ëï3ÃÕÃ»ñ áñáÝù Ó»1⁄2 Ïû·Ý»Ý Ñ3ñó»ñÁ 

å3ï3ëË3Ý»Éáõ

• Ð3ßí»óáõó3ÏÝ»ñ, áñáÝù óáõÛó »Ý ï3ÉÇë 

Ó»ñ Ñ3ßÇíÝ»ñÇ ·áõÙ3ñÁ 1ñ3Ù3ï3Ý Ù»ç, 

í3ñÏ3ÛÇÝ ÙÇáõÃÛáõÝÝ»ñáõÙ Ï3Ù 3ÛÉ 1ñ3Ù3Ï3Ý 

Ñ3ëï3ïáõÃÛáõÝÝ»ñáõÙ.

• Ð3ßí»óáõó3ÏÝ»ñ Ý»ñ1ñáõÙÝ»ñÇ Ù3ëÇÝ.

• Ð3ßí»óáõó3ÏÝ»ñ ÏÛ3ÝùÇ 3å3Ñáí3·ñáõÃÛ3Ý 

íÏ3Û3Ï3ÝÝ»ñÇó.

•  ́3ÅÝ»ïáÙë»ñ.

• Ð3ñÏ3ÛÇÝ Ñ3Ûï3ñ3ñ3·ñ»ñ.

• ö3ëï3ÃÕÃ»ñ Ï»Ýë3Ãáß3ÏÇ í»ñ3μ»ñÛ3É. 

• ì×3ñÙ3Ý Ñ3ßí»óáÛó:

 ̧áõù ÇÝãå»±ë Ï3ñáÕ »ù ëï3Ý3É 

Ñ3í»ÉÛ3É ï»Õ»ÏáõÃÛáõÝ

oÃ» áõ1⁄2áõÙ »ù 1ÇÙáõÙÝ3·Çñ ëï3Ý3É, 

Ñ»é3Ó3ÛÝ»ó»°ù êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛ3Ý 

3Ýí×3ñ ÃÇõÇÝa 1-800-772-1213 (ËáõÉ»ñÁ »õ 

1Åí3ñ ÉëáÕÝ»ñÁ Ï3ñáÕ »Ý Ñ»é3Ó3ÛÝ»É Ñ»ï»õ»3É 

Ñ3ïáõÏ ÃÇõÇÝ TTY 1-800-325-0778) »õ ËÝ1ñ»ó»°ù 

Application for Help with Medicare Prescription Drug 

Plan Costs (SSA-1020) §Ø¿ïÇù¿ñÇ  ̧»Õ3·Çñáí 

 ̧»Õáñ3Ûù ¶Ý»Éáõ Ìñ3·ñÇ Ì3Ëë»ñÁ Ðá·3Éáõ 

 ̧ÇÙáõÙÝ3·ÇñÁ» (SSA-1020)¦:  ̧áõù Ï3ñáÕ »ù 

1ÇÙ»É Ù»ñ áëï3ÛÝ¿çáía www.socialsecurity.gov: 

Ø¿ïÇù¿ñÇ 1»Õ3·Çñáí 1»Õáñ3Ûù ·Ý»Éáõ

Íñ3·ñÇ Ù3ëÇÝ Ñ3í»ÉÛ3É ï»Õ»ÏáõÃÛáõÝ 

1-800-MEDICARE (1-800-633-4227) Ï3Ù

3Ûó»É»ó»°ù www.medicare.gov.

In 2007, the annual income limit is $15,315 

($20,535 for a married couple living together). The 

resource limit is $11,710 for an individual ($23,410 

for a married couple living together). This publication 

will be updated soon.

ÊÝ1ñíáõÙ ¿ ß3ñáõÝ3Ï»É ¿çÇ Ñ3Ï3é3Ï ÏáÕÙáõÙa 

3ßË3ï3Ýù3ÛÇÝ 3ÕÛáõë3ÏÁ Éñ3óÝ»Éáõ Ñ3Ù3ñ:

(ßñç»ÉÇ)

ô±Ýã ä»ïù àõÝ»ù Ø¿ïÇù¿ñÇ  ̧»Õ3·Çñáí  ̧»Õáñ3Ûù ¶Ý»Éáõ w w w . s o c i a l s e c u r i t y . g o v Ìñ3·ñÇ Ì3Ëë»ñÁ Ðá·3Éáõ  ̧ÇÙáõÙÝ3·ÇñÁ 2ÙμáÕç3óÝ»Éáõ Ð3Ù3ñ

2007
Ø»Ýù å»ïù ¿ ï»Õ»ÏáõÃÛáõÝ ëï3Ý3Ýù Ó»ñ »Ï3ÙáõïÇ »õ 1ñ3Ù3Ï3Ý ÙÇçáóÝ»ñáõ Ù3ëÇÝ (Ý3»õ Ó»ñ 

ÏÝáç Ï3Ù 3ÙáõëÝáõa»Ã» 1áõù 3ÙáõëÝ3ó3Í »ù »õ 3åñáõÙ ÙÇ3ï»Õ).

2ÝáõÝ êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛ3Ý Ð3Ù3ñÝ

___________________________________________________ ___________________________________________________ 

 ̧ñ3Ù3Ï3Ý ØÇçáóÝ»ñ 2ñÅ»ù

 ̧ñ3Ù3ï3Ý Ñ3ßÇíÝ»ñ, Ý»ñ3éÛ3É í×3ñ3·Çñ, ËÝ3ÛáÕ3Ï3Ý 

»õ 3í3Ý13ÛÇÝ íÏ3Û3·ñ»ñ ______________________________________________ 1áÉ3ña

 ́3ÅÝ»ïáÙë»ñ, å3ñï3ïáÙë»ñ, ËÝ3ÛáÕ3Ï3Ý 

å3ñï3ïáÙë»ñ, 3ÝÑ3ï3Ï3Ý Ï»Ýë3Ãáß3Ï3ÛÇÝ Ñ3ßÇíÝ»ñ 

(IRA) Ï3Ù 3ÛÉ Ý»ñ1ñáõÙÝ»ñ ______________________________________________ 1áÉ3ña

Î3ÝËÇÏ 1ñ3Ù Ó»ñ ï3Ý Ù¿ç Ï3Ù áñ»õ¿ áõñÇß ï»Õ ______________________________________________ 1áÉ3ña

ÎÛ3ÝùÇ 3å3Ñáí3·ñáõÃÛ3Ý íÏ3Û3Ï3ÝÝ»ñ Ó»1⁄2 Ñ3Ù3ñ 

(»õ Ó»ñ ÏÝáç Ï3Ù 3ÙáõëÝáõ Ñ3Ù3ña »Ã» 3ÙáõëÝ3ó3Í »ù »õ 

3åñáõÙ ÙÇ3ï»Õ) ______________________________________________ 1áÉ3ña

Ì2ÜàôòàôØ. êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛáõÝÁ å¿ïù ¿ ÇÙ3Ý3, Ã» áñù3Ý 1ñ3Ù 1áõù Ï3ñáÕ »ù ëï3Ý3É »Ã» Ó»ñ 

ÏÛ3ÝùÇ 3å3Ñáí3·ñáõÃÛ3Ý íÏ3Û3Ï3ÝÇ Ï3ÝËÇÏ ·áõÙ3ñÁ ëï3Ý3ÛÇù 3Ûëûñ: Î3ÝËÇÏ ·áõÙ3ñÇ ×ß·ñÇï ã3÷Á ×ßï»°ù Ó»ñ 

3å3Ñáí3·ñ3Ï3Ý ÁÝÏ»ñáõÃÛ3Ý Ï3Ù ·áñÍ3Ï3ÉÇ Ñ»ï: 2ÛÝ Ñ3í3Ý3μ3ñ ÏÉÇÝÇ 3õ»ÉÇ Ýí31⁄2 ù3Ý 3å3Ñáí3·ñí3Í ·áõÙ3ñÁ:

àñ»õ¿ 3Ýß3ñÅ Ï3Éí3Í, μ3óÇ Ó»ñ ïÝÇó ______________________________________________ 1áÉ3ña 

oÏ3Ùáõï 2Ùë3Ï3Ý ·áõÙ3ñ

êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛ3Ý Ýå3ëïÝ»ñ ______________________________________________ 1áÉ3ña

oñÏ3Ã·ÍÇ 3ßË3ïáÕÝ»ñÇ Ï»Ýë3Ãáß3Ï ______________________________________________ 1áÉ3ña

ì»ï»ñ3ÝÝ»ñÇ Ýå3ëïÝ»ñ ______________________________________________ 1áÉ3ña

2ÛÉ Ï»Ýë3Ãáß3ÏÝ»ñ »õ ï3ñ»í×3ñÝ»ñ ______________________________________________ 1áÉ3ña

2åñ»É3ÙÇçáó (3ÙáõëÝ3ÉáõÍí3Í 3ÝÓÇ »Ï3ÙáõïÁ Ý3ËÏÇÝ 

3ÙáõëÝáõ Ï3Ù ÏÝáç ÏáÕÙÇó) ______________________________________________ 1áÉ3ña

1⁄4áõï »Ï3Ùáõï í3ñÓùÇó ______________________________________________ 1áÉ3ña

 ́3Ýíáñ3Ï3Ý ÷áËÑ3ïáõóáõÙÝ»ñ ______________________________________________ 1áÉ3ña

2ÛÉ Ù3ñ1Ï3Ýó ÏáÕÙÇó ïñ3Ù31ñí3Í û·ÝáõÃÛáõÝ ïÝ3ÛÇÝ 

Í3Ëë»ñÇ Ñ3Ù3ña ûñÇÝ3Ï áõï»ÉÇùÇ, ·ñ3íÇ Ï3Ù í3ñÓùÇ, 

ç»éÙáõÃÛ3Ý í3é»ÉÇùÇ Ï3Ù ·31⁄2Ç, »É»Ïïñ3Ï3ÝáõÃÛ3Ý, çáõñÇ 

»õ ï3Ý Ñ3ñÏ»ñÇ í×3ñáõÙÝ»ñ ______________________________________________ 1áÉ3ña

2ßË3ï3í3ñÓ ______________________________________________ 1áÉ3ña

ÆÝùÝ3ßË3ïáõÃÛáõÝÇó 3é3ç3ó3Í 1⁄2áõï »Ï3Ùáõï ______________________________________________ 1áÉ3ña

2ÛÉ »Ï3Ùáõï ______________________________________________ 1áÉ3ña

Î3ñáÕ »ù êáóÇ3É3Ï3Ý 2å3ÑáíáõÃÛ3Ý Ñ»ï Ó»ñ Ñ3ñó»ñÁ ÉáõÍ»É Ý»ñÏ3Û3óáõóÇãÇ ÙÇçáóáí: Ø»Ýù Ó»ñ 

Ý»ñÏ3Û3óáõóÇãÇ Ñ»ï Ï3ßË3ï»Ýù 3ÛÝå»ë ÇÝãå»ë Ó»1⁄2 Ñ»ï:

w w w . s o c i a l s e c u r i t y . g o v

Social Security Administration

SSA Publication No. 05-10128-AM

What You Need To Complete The Application For Help 

 With Medicare Prescription Drug Plan Costs (Armenian)

January 2007