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Connecticut State Pharmacy Assistance Programs (SPAP)

Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled Program (PACE)




Eligiblity Requirements

You must meet the following requirements:
  • You must be a Connecticut resident for 6 months prior to applying.
  • You must be 65 years of age or older or be a disabled person over the age of 18.
  • You must pay a $45 annual enrollment fee per person.
  • You must not be receiving Medicaid benefits.
  • You must not have an insurance plan that pays for all or a portion of each prescription on a continuous basis or have a deductible insurance plan that includes prescriptions.
  • You must have an adjusted gross income of less than $26,400 if single or $35,600 if married.
  • You must sign up for Medicare Part D if Medicare eligible.



Important Note

  • Due to a change in the Connecticut state budget, effective July 1, 2011, ConnPACE will no longer be available to individuals who are eligible for Medicare.
  • The ConnPACE program will be available to only those individuals who meet all of the current ConnPACE eligibility requirements and are NOT eligible for Medicare.
  • Most current ConnPACE members, therefore, will no longer qualify for ConnPACE because they are eligible for Medicare.
  • Medicare Part D will be the only insurance that covers their prescription drugs.
  • The ConnPACE program will only pay Medicare Part D Prescription Drug Plan premiums on behalf of members who are enrolled in one of the Connecticut-approved Medicare Part D ‘benchmark’ plans.
  • The ConnPACE program will NOT pay for Medicare Part D prescriptions that are not covered by your Part D plan. These are drugs that are not on your Part D Plan’s formulary (which means approved drug list).
  • If your doctor prescribes a drug for you that is not on your Medicare Part D Plan’s formulary, the pharmacist should contact your physician to discuss other drugs that are covered by your Medicare Part D Plan. Your doctor may either change your prescription to a drug that is covered by your Medicare Part D Plan, or may ask your Medicare Part D Plan to grant an exception or authorization for that drug to be covered. If the specific drug is medically necessary for you to receive and is not covered by your Part D plan, your doctor must ask the Part D Plan for this exception or authorization.

    It is important to remember that this only applies to drugs that are non-formulary or require prior authorization under your Medicare Part D Plan. Medicare Part D excluded drugs will continue to be covered by the Department as they have in the past (i.e. Benzodiazepines, Barbiturates).
  • There is an annual ConnPACE open enrollment period from November 15 to December 31 of each year with eligibility beginning January 1. The ConnPACE open enrollment period coincides with the annual open enrollment period for the Medicare Part D Program and is for NEW applicants only.

    New ConnPACE applications will NOT be accepted outside of the open enrollment period unless the applicant is within 31 days of his/her 65th birthday or becoming eligible for Social Security Disability or Supplemental Security Income.

    Again, the ConnPACE open enrollment period does NOT apply to current ConnPACE members. Individuals who are currently eligible for ConnPACE will continue to renew their benefits in the month their renewals are due. However, we wanted to remind you about the open enrollment period in case you let your ConnPACE enrollment expire for some reason and want to re-enroll. If you do let your ConnPACE benefits expire, you will have to wait for the next open enrollment period.



Contact Information

Phone
(800) 423-5026
(860) 269-2029

Address
P.O. Box 5011
Hartford, CT 06102


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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
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  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.