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MedicarePartD.guide

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Maryland State Pharmacy Assistance Programs (SPAP)


Maryland State Pharmacy Assistance Programs

Maryland Senior Prescription Drug Assistance Program


Eligibility Requirements:
  • Maryland residents enrolled in MedicareRx may be eligible for prescription drug subsidies under the Maryland Senior Prescription Drug Assistance Program (SPDAP).

  • You may be eligible for SPDAP if you are enrolled in a MedicareRx plan or Medicare Advantage Prescription Drug plan.
  • Reside in Maryland for at least 6 months.

  • Have income up to 300% FPL, have no other prescription drug benefits, and are not eligible for full federal extra help with MedicareRx coverage (Low Income Subsidy).
Important Notes:
  • SPDAP will pay up to $50.00 per month for a member’s Medicare Rx prescription drug plan premium, as long as the individual is enrolled in an approved Medicare prescription drug plan or a Medicare Advantage prescription drug plan. There are 58 different prescription benefit plans and Medicare Advantage drug plan options from which to choose. A complete list of Stand Alone Rx Plans may be found here. Follow this link for a complete list of Medicare Advantage Plans.

  • Note: The SPDAP Coverage Gap subsidy was discontinued at the end of 2020.

  • If you are approved in SPDAP, we will notify Medicare of your membership in the program. Medicare will then advise us of the Medicare Rx prescription drug plan or Medicare Advantage Plan in which you are enrolled. This process may take 60 to 90 days. If you wait to enroll in a drug plan, the process will take longer.

  • Once Medicare informs us of the Medicare Rx prescription drug plan or Medicare Advantage Plan in which you are enrolled, we will pay up to $50 for each month after your effective date with SPDAP.

  • DO NOT have your Medicare Rx premium automatically deducted from your Social Security check. If you are currently having your premium deducted from your Social Security Check, contact your Prescription Drug Plan and request direct billing.

  • PLEASE NOTE: SENDING AN INCOMPLETE APPLICATION OR NOT ENCLOSING THE REQUIRED DOCUMENTATION MAY RESULT IN A DELAY AND REDUCTION IN THE AMOUNT OF SPDAP SUBSIDES YOU RECEIVE THIS YEAR.
Contact Information: Phone
(800) 551-5995

Address
Maryland SPDAP

c/o Pool Administrators
628 Hebron Avenue
Suite 212
Glastonbury, CT 06033
» Maryland Senior Prescription Drug Assistance Program




Maryland Kidney Disease Program


Eligibility Requirements: The Kidney Disease Program (KDP) provides reimbursement for approved services required as a direct result of end-stage renal disease (ESRD). KDP eligibility is offered to Maryland residents who are:
  • Citizens of the United States or aliens lawfully admitted for permanent residence in Maryland;
  • Diagnosed with ESRD; and
  • Receiving home dialysis or treatment in a certified dialysis or transplant facility.
Eligibility Requirements: A patient is eligible to request financial assistance from the Kidney Disease Program when he/she begins chronic maintenance dialysis in a certified hospital or certified freestanding dialysis facility, or receives a renal transplant in a certified transplantation center.

Based upon financial information provided by a patient at the time of certification/recertification, the Kidney Disease Program may assess an annual Program participation fee. This fee is based on 5% of the amount by which the family income exceeds 175% of poverty level and/or liquid assets exceed 200% of the poverty level guideline adjusted for the family size. The annual participation fee is due quarterly by specified payment dates. Annual recertification is required in order to maintain continuity of Kidney Disease Program coverage.

Covered services related to ESRD include:
  • Chronic maintenance in-center and home dialysis,

  • Renal transplantation,

  • Approved inpatient and/or outpatient hospital care,

  • Physician fees,

  • Laboratory tests,

    • Prescription and over-the-counter items in the Kidney Disease Program Reimbursable Drug List (for enrollees who are not Medicare beneficiaries),
  • Approved Medicare deductibles and coinsurance.
Program will be the secondary payor for people enrolled in a Medicare Prescription Drug Plan Part A, B & D.
Eligibility Requirements: Phone
(410) 767-5000
(800) 226-2142

Address
Maryland Kidney Disease Program
201 West Preston Street - Room SS-3
Baltimore, MD 21201
» Maryland Kidney Disease Program




Primary Adult Care Program (PAC)


Eligibility Requirements: You may receive health care services from PAC if you:
  • Are a Maryland resident ages 19 and over,

  • Are not on Medicare,
  • Are a U.S. citizen or a qualified alien who meets all requirements for benefits, and
  • Have income below 116% of the Federal Poverty Level (about $13,537 for one person
    or $18,247 for two people).
  • You do not need to have a medical disability to qualify.

  • You may apply for benefits for yourself or for you and your spouse on the same application.
Important Notes: Persons who are not Medicare beneficiaries and are not eligible for full Medicaid benefits may qualify for coverage of pharmacy benefits through the Primary Adult Care program (PAC).

PAC helps low-income individuals, age 19 and older, pay for the full range of pharmacy services covered under the Medical Assistance Program. The PAC program also covers basic health services.

On January 1, 2014, all active PAC particiapnts will automatically receive full Medicaid benefits.
Contact Information: Phone
(800) 226-2142

Address
Primary Adult Care Program
P.O. Box 386
Baltimore, MD 21203
» Primary Adult Care Program (PAC)