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State Pharmacy Assistance Programs

 State Pharmacy Assistance Programs - are state-funded programs that provide low-income and medically needy senior citizens and individuals with disabilities financial assistance for prescription drugs. As noted by Medicare:

"The law allows State Pharmacy Assistance Programs to "wrap around" the Medicare benefit to fill gaps in coverage. As a result, State Pharmacy Assistance Programs will be able to provide the same or better coverage for the beneficiaries who receive coverage through state programs now, at a lower cost per beneficiary for the states because of the availability of the Medicare drug benefit."

A number of states are offering various programs that may help with monthly Medicare Part D plan premiums or even medication copayments, which will ultimately be considered as a portion of the TrOOP or True out of Pocket expenses that you pay.

Qualified State Pharmaceutical Assistance Programs Under the MMA*
*Note: This list is based on qualified SPAP attestation forms received by CMS as of April 15, 2008. Please note that several states have more than one SPAP.

Click on the state or program name below for program details

State or Territory Program Name
Colorado :: Colorado Bridging the Gap
Connecticut :: Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled Program (PACE)
Delaware :: Delaware Prescription Assistance Program (PDAP)
:: Delaware Chronic Renal Disease Program
Florida :: Florida Comprehensive Health Association (High Risk Pool)
Idaho :: Idaho AIDS Drug Assistance Program (IDAGAP)
Illinois Illinois Cares Rx
Indiana :: Hoosier Rx
Maine :: Low Cost Drugs for the Elderly and Disabled Program
Maryland :: Maryland Senior Prescription Drug Assistance Program
:: Maryland Kidney Disease Program
:: Primary Adult Care Program (PAC)
Massachusetts :: Prescription Advantage
Missouri :: Missouri Rx Plan
Montana :: Big Sky Rx Program
:: Montana Mental Health Services Plan (MHSP)
Nevada :: Disability Rx Program
:: Senior Rx Program
New Jersey :: Prescription Assistance to the Aged and Disabled Program (PAAD)
:: New Jersey Senior Gold Prescription Discount Program
:: New Jersey Division of Medical Assistance and Health Services
New York :: Elderly Pharmaceutical Insurance Coverage (EPIC)
North Carolina :: North Carolina HIV SPAP
Pennsylvania :: Pharmaceutical Assistance Contract for the Elderly (PACE)
:: PACE Needs Enhancement Tier (PACENET)
:: Pennsylvania Chronic Renal Disease Program and General Assistance Program
:: Special Pharmaceutical Benefits Program - HIV/AIDS & Special Pharmaceutical Benefits Program - Mental Health
Rhode Island :: Rhode Island Prescription Assistance for the Elderly (RIPAE)
South Carolina :: Gap Assistance Program for Seniors (GAPS)
Texas :: Kidney Health Care Program
:: HIV SPAP
US Virgin Islands :: Senior Citizens Affairs Pharmaceutical Assistance Program
Vermont :: VPharm, Vermont Health Access Plan (VHAP-Pharmacy), VSCRIPT Expanded and Vermont VPHARM
Virginia :: Virginia HIV SPAP
Washington :: Washington State Health Insurance Pharmacy Assistance Program
Wisconsin :: Cystic Fibrosis Program
:: Health Insurance Risk Sharing Plan (HIRSP)
:: Hemophilia Home Care
:: SeniorCare




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  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
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  • 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 PDPCompare.com and MACompare.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.
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    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • 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.
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