Medicare Rights Center

State Pharmaceutical Assistance Programs (SPAPs)

Many states offer a state pharmaceutical assistance program (SPAP) to help their residents pay for prescription drugs. Each program works differently.

Many states coordinate their SPAPs with Medicare’s drug benefit (Part D). If you have Medicare and do not have Part D, but qualify for your state’s SPAP, you may be required to enroll in a Part D plan.

If a drug is covered by both your SPAP and your Part D plan, what you pay plus what the SPAP pays for the drug will count towards the out-of-pocket maximum you have to reach before your Medicare drug costs go down.

See the chart below to find out if your state has an SPAP, whether you are eligible, how the SPAP works, and how to enroll.

State Pharmaceutical Assistance Programs

(Scroll down on the right side of the chart to see information for the SPAP in your state.)

  Eligibility Assistance Enrollment1
Program Age Income (Individual/Couple) Requires Part D? Assistance with Co-Pays? Helps Pay Part D Premium? Helps Pay Part D Deductible? Requires Extra Help (LIS)? Is It Free?
1If you need emergency assistance paying for a prescription drug, your SPAP may be able to help. Call to find out.
Colorado

Bridging the Gap (ADAP)

303-692-2148

No age restrictions, but must be HIV positive. 1 person/family or household ($43,320); 2 person/family or household ($58,280); 3 person/family or household ($73,240); 4 person/family or household ($88,200). For each additional family member, add $14,960. Yes. Yes. Yes. Yes. No. Yes.
Connecticut

Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled (ConnPACE)

800-423-5026

65+ (or 18+ with disabilities) $25,100/$33,800 Yes. Yes. Yes, for benchmark plans only. Yes. Yes. No. You pay $45/year.
Delaware

Chronic Renal Disease Program

800-372-2022

No age restrictions, but must have ESRD. $32,490/$43,710 Yes. Yes. Yes. Yes. Yes. Yes
Delaware

Prescription Assistance Program

800-996-9969

65+ (or under 65 and receiving SSDI) $21,660/$29,140, or prescription costs are greater than 40% of annual income Yes. Yes. Yes. Yes. Yes. Yes.
Idaho

Idaho HIV State Prescription Assitance

208-367-6079

No age restrictions, but must be HIV positive. $16,245 - $21,660 / $21,855- $29,140 Yes. Yes. No. No. No. Yes.
Illinois

Illinois Cares Rx Basic

800-252-8966

65+ (or 16+ with disabilities). $25,532/$33,877 Yes. Yes. Yes. Yes. Yes. Yes.
Illinois

Illinois Cares Rx Plus

800-252-8966

65+ (or 18+ with disabilities). $24,891/$33,487 Yes. Yes. Yes. Yes. Yes. Yes.
Indiana

Hoosiers Rx

866-267-4679

65+ $16,485/$22,095 Yes. No. Yes (up to $70/month). No. Yes. Yes.
Maine

Low Cost Drugs for the Elderly and Disabled Program (DEL)

800-262-2232

62+ (or 19+ and disabled). $20,036/$26,955 Yes. Yes. Yes. Yes. No. Yes.
Maryland

Kidney Disease Program of Maryland (KDP)

410-767-5000

No age restrictions, but must have ESRD. No income restrictions. Yes. Yes. No. No. No. No. Fee depends on income.
Maryland

Maryland Senior Prescription Drug Assistance Program

800-551-5995

65+ $32, 490/$42,710 Yes. SPAP pays up to $1,200/year toward Part D prescriptions during the donuthole. Yes (up to $25/month). No. Yes. Yes.
Massachusetts

Prescription Advantage

800-243-4636

65+ (or under 65 with disabilities). $54,150/$72,850; disabled: $20,360/$27,392 Yes. Yes. Yes. Yes. Yes. Yes.
Missouri

Missouri Rx Plan (MORx)

800-375-1406

65+ (or under 65, disabled and receiving Medicare). $21,660/$29,140 Yes. Yes. No. Yes. No. Yes.
Montana

Big Sky Rx Program

866-369-1233

65+ (or under 65, disabled and receiving Medicare). $21,660/$29,140 Yes. No. Yes. No. Yes. Yes.
Montana

Montana Mental Health Service Plan

800-551-3191

18+ with severe and disabling mental illness (SDMI) Single ($15,600); 2 person household ($21,000); 3 person household ($26,400) Yes. MHSP will pay up to $425/month in assistance. Money can be used towards copayments. Part of $425 can be used to pay for the Part D premium. Part of $425 can be used to pay for the Part D deducitble. No. Yes.
Nevada

Senior Rx

866-303-6323

62+ $24,477/$33,963 Yes, if eligible. Yes. SPAP pays 100 percent of your out-of-pocket costs during donut hole. Yes. No. Yes. Yes.
Nevada

Disability Rx

866-303-6323

18 - 61 with a verifiable disability. $24,561/$32,742 Yes, if eligible. Yes. SPAP helps you cover out-of-pocket costs during donut hole. (If you are not eligible for Medicare, you pay $10 - $25/prescription). Yes. No. Yes. Yes.
New Jersey

Prescription Assistance to the Aged and Disabled Program (PAAD)

800-792-9745

65+ (or 18+ and receiving SSDI). $24,432/$29,956 Yes. Yes. Yes. Yes. Yes. Yes.
New Jersey

Senior Gold

800-792-9745

65+ (or 18+ and receiving SSDI). $24,432-$34,432/$29,956- $39,956 Yes. Yes. No. Yes. Yes.. Yes.
New Jersey

General Public Assistance Program Medicare D Wraparound

65+ or disabled and must have both Medicare and Medicaid. $10,836 / $14,580, or must qualify for Medicaid through a spend down. Yes. Yes, but only for non-formulary drugs or those excluded by Medicare law.. No. N/A (You should already have Extra Help, and therefore no deductible). N/A Yes.
New York

Elderly Pharmaceutical Insurance Coverage (EPIC)

800-332-3742

65+ $35,000/$50,000 Yes. Yes. Yes. Yes. Yes. No. Cost is based on income.
North Carolina

NCRx

888-488-6279

65+ $18,952/$25,497 Yes. No. Yes. No. Yes. Yes.
Pennsylvania

Pharmaceutical Assistance Contract for the Elderly (PACE)

800-225-7223

65+ $14,500/$17,700 No. Yes. Yes. Yes. No. Yes.
Pennsylvania

PACE Needs Enhancement Tier (PACENET)

800-225-7223

65+ $23,500/$31,500 No. Yes. Yes. No.. No. No. There is a $32.09 monthly deductible if not enrolled in Part D..
Pennsylvania

Pennsylvania Chronic Renal Disease Program

800-225-7223

No age restrictions, but must have ESRD. $32,490/$43,710 No. Yes. Yes. Yes. No. Yes.
Pennsylvania

Special Pharmaceutical Benefits Program

800-922-9384

No age restrictions, but must be HIV positive or a diagnosis of schizophrenia. $35,000 (only your individual income is counted). No. Yes. Yes. Yes. No. Yes.
Rhode Island

Rhode Island Prescription Assistance for the Elderly (RIPAE)

401-462-4000

65+ (or 55-64 and receiving SSDI). Level 1: $20,934/$26,170

Level 2: $26,279/$32,851

Level 3: $45,991/$52,661

Yes. Yes. No. No. Yes. Yes.
South Carolina

Gap Assistance Program for Seniors

888-549-0820

65+ $21,660/$29,140 Yes. No. No. No. Yes. Yes.
Texas

Kidney Health Care Program

800-222-3986

No age restrictions, but must have ESRD. Total household income must be below $60,000. Yes. Yes. Yes. Yes. Yes. Yes.
Texas

HIV SPAP

800-255-1090

No age restrictions, but must be HIV positive. $21,660/$29,140 Yes. Yes. SPAP pays up to $10.995 om 2009 for SPAP cost sharing. No. Yes. Yes. Yes.
Vermont

Vpharm 1, 2, OR 3

800-250-8427

65+ (or under 65 and receiving SSDI). Vpharm 1: $16,308/$21,948

Vpharm 2: $19,032/$25,608

Vpharm 3: $24,468/$32,928

Yes. Yes. Depends on income. Yes. Yes Yes, if eligible for Vpharm 1. No. Monthly premium ranges from $15 - $50.
Virginia

Virginia Department of Health HIV SPAP

800-366-7741

No age restrictions, but must be HIV positive. Between $14,620.50 and $32,490/Between $19,669.50 and $43,710 Yes. Yes, for those already enrolled (discontinued indefinitely for new recipients). Yes. Yes, for those already enrolled (discontinued indefinitely for new recipients). Yes. Yes.
Washington

Washington State Health Insurance Pharmacy Assistance Program

800-657-2038

No age restrictions. No income restrictions. Yes Yes. No. Yes. No. No. Fee ranges from $163 to $487, depending on age and income.
Wisconsin

SeniorCare

800-657-2038

65+ Level 1: $17,328/$23,312

Level 2a: $21,660/$29,140

Level 2b: $25,661/$34,968

Level 3: $25,993+/$34,969+

No. (SeniorCare is considered creditable). Yes. No. No. No. No; $30 annual fee.
Wisconsin

Wisconsin Chronic Renal Disease Program

608-221-3701

No age restrictions, but must be have ESRD. No income restrictions. Yes. Part D or creditable coverage is required. Yes, for ESRD-related prescriptions. Yes. Yes. Yes. Yes.
Wisconsin

Adult Cystic Fibrosis Program

800-362-3002

18+ and diagnosed with cystic fibrosis. No income restrictions. Yes, if eligible. Yes, for limited prescriptions related to cystic fibrosis. Yes. Yes. Yes. Yes.
Wisconsin

Hemophilia Home Care (HHC)

800-362-3002

No age restrictions, but must be diagnosed with hemophilia. No income restrictions. Yes, if eligible. Yes, for limited prescriptions related to hemophilia. Yes. Yes. Yes. Yes.
Wisconsin

Health Insurance Risk Sharing Plan

800-828-4777

Younger than 65. No income restrictions. Yes. Yes. No. Yes. No. No.
U.S. Virgin Islands

Senior Citizens Affairs

340-774-0903

60+ $18,000/$30,000 Yes. Yes. Yes. Yes. No. No.