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Ilinois State Pharmacy Assistance Programs

Circuit Breaker and Pharmaceutical Assistance, and Illinois SeniorCare




Eligiblity Requirements

Circuit Breaker and Pharmaceutical Assistance:
To qualify, you must meet all of the following requirements:
  • You must have been 65 years of age or older before January 1, 2005; or You must become 65 years of age during 2005 (for a partial grant); or You must have been 16 years of age or older before January 1, 2005, and totally disabled; or you must be a widow or widower who turned 63 or 64 years of age before the deceased claimant's death; and
  • You must have lived in an Illinois residence in 2003 that was subject to property or mobile home tax; and
  • You must live in Illinois at the time you file the application; and
  • Your total income in 2004 must be less than $21,218 if filing an application for yourself only; 28,480 if filing an application for yourself and your spouse*, or yourself and one qualified additional resident, or $35,740 if filing an application for yourself, your spouse and at least one qualified additional resident, or yourself and at least two qualified additional residents. * If your spouse lives with you, you must add your spouse's income to your income. ** Do not include any qualified additio


Illinois SeniorCare:
You can enroll in SeniorCare if you meet the following criteria:
  • Group 1: Seniors age 65 or older. If single, income not to exceed $19,140; if married, income not to exceed $25,660. Must be a citizen or a qualified non-citizen. or,
  • Group 2: Seniors or persons with disabilities with incomes less than $21,219 if single; if married, income not to exceed $28,480. No citizenship requirement.




Important Note

Circuit Breaker and Pharmaceutical Assistance:
You can apply for the program by calling the toll free number listed above or by visiting the Circuit Breaker and Pharmaceutical Assistance Website. Toll free number can be accessed only within Illinois.
  • The program covers approved medications used for the treatment of Alzheimer's disease, arthritis, cancer, cardiovascular disease, diabetes, glaucoma, lung disease and smoking-related illness, multiple sclerosis, osteoporosis, and Parkinson's disease.
  • Coverage will cost $5.00 and you will not have a copayment for your prescriptions if:

    • your marital status is single and your total income is less than $8,590;

    • your marital status is married and living separately and your total income is less than $8,590; or

    • your marital status is married and living together, and your total income is less than $11,610

  • Coverage will cost $25.00 and you will have a $3.00 copayment for each prescription if:

    • your marital status is single and your total income is $8,590 or more;

    • your marital status is married


Illinois SeniorCare:
If not eligible for Part D, copayments are $2/$5. Once the SPAP has paid $1750 in benefits, the beneficiary will pay 20% coinsurance in addition to the copayments. Group 1: Covers all classes of drugs. Group 2: Covers drugs used to treat. Alzheimer's disease, arthritis, cancer, diabetes, glaucoma, cardiovascular disease, lung disease and smoking-related illnesses, osteoporosis, Parkinson's disease and multiple sclerosis." The Circuit Breaker SPAP and Senior Care Pharmacy Plus programs will merge to become Illinois Cares Rx. $2/$5 copayments. Once the SPAP has paid $1750 in benefits, the beneficiary will pay 20% coinsurance in addition to the copayments. Two PDPs have agreed to accept the state's lump sum payment option. Group 1: After $5,100 of Rx drug spending by state and Medicare, coinsurance for Medicare beneficiaries drops to 5%. State completed auto-assignment in November. Next phase to begin mid-January, for those who have signed up for the SPAP since November 1, 2005. Auto-assignment will continue twice a month by the 15th and clean up file by the 23rd New cards were mailed in December.




Contact Information


  Circuit Breaker and Pharmaceutical Assistance Illinois SeniorCare
Phone (800) 624-2459 (800) 226-0768
Address P.O. Box 19022
Springfield, IL 62794
SeniorCare Illinois Department on Aging
P.O. Box 19021
Springfield, IL 62794


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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.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • 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.