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.
| 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
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
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
800-252-8966 |
65+ (or 16+ with disabilities). | $25,532/$33,877 | Yes. | Yes. | Yes. | Yes. | Yes. | Yes. | |
| Illinois
800-252-8966 |
65+ (or 18+ with disabilities). | $24,891/$33,487 | Yes. | Yes. | Yes. | Yes. | Yes. | Yes. | |
| Indiana
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
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
800-375-1406 |
65+ (or under 65, disabled and receiving Medicare). | $21,660/$29,140 | Yes. | Yes. | No. | Yes. | No. | Yes. | |
| Montana
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
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
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
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
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
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
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
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
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
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
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
340-774-0903 |
60+ | $18,000/$30,000 | Yes. | Yes. | Yes. | Yes. | No. | No. | |