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State Pharmaceutical Assistance Programs (SPAPs)

What is an SPAP?

Many states have programs to help people with limited incomes – especially seniors and people with certain illnesses – to pay for their prescriptions. Many of these programs work with Medicare Part D, “wrapping around” coverage, meaning they help pay for certain costs that Part D does not cover. These programs are known as State Pharmacy Assistance Programs, or SPAPs. Different states may call their SPAPs by different names.

Is there an SPAP in my state?

While many states have SPAPs, not all of them do. Find out if your state has a program.

How do these programs work?

Because each state runs its own program, each SPAP is different. Some give you discounts on your prescriptions, while others offer certain medicines for a low, fixed price – called a copayment. For more information, contact the SPAP in your state.

I am in a Part D plan. Can I still get into an SPAP?

Yes. Most SPAPs work with the Medicare Part D in some way. It depends on your state. Some SPAPs offer wrap-around coverage, which helps you with costs and drugs that Medicare does not cover. Your SPAP may have relationships with plans in your state and may require you to join one of the plans they work with. Some SPAPs may even enroll you in a plan.

Talk with the people at your SPAP to see what they do. They can tell you what your options are if you sign up now.

Do I qualify for the SPAP in my state?

While these programs usually are for people with limited incomes, the rules are different in each state. You can find out if you might qualify for the one in your state by completing the “BenefitsCheckUp” questions. Through BenefitsCheckUp, you can also get the application for the SPAP in your state, if your state has an SPAP.

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