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Help from the Maryland Senior Prescription Drug Assistance Program

The state government of Maryland created the Senior Prescription Drug Assistance Program (SPDAP). The resource was intended to be a free or low cost prescription subsidy program that will provide financial assistance to both low income as well as moderate-income Maryland residents. The SPDAP program is managed by the Maryland Health Insurance Plan, and find how to apply below. This is an independent agency of the State of Maryland, and they have in place their own Board of Directors who manage the organization.

There are conditions that must be met in order to participate in the Senior Prescription Drug Assistance Program. They include the following requirements:

  • The applicant needs to be eligible for Medicare and they need to be currently enrolled in a prescription drug plan or program
     
  • They must have a total household income level that is at or below 300% of the Federal Poverty Level
     
  • Be a Medicare recipient
     
  • The applicant must have lived in Maryland for at least six months

The program continues to expand each and every year, and the number of people who benefit from it increase. For example, this year the Senior Prescription Drug Assistance Program received almost $20 million in additional funding from the state of Maryland as well as the CareFirst Blue Cross Blue Shield health insurance agency. These additional funds allow it to offer a new subsidy that is designed to assist senior citizens who are currently taking medication that costs more than the annual $2,830 initial coverage limit.

Under the current plan, after that $2,830 coverage limit is reached, seniors will then fall into the infamous “doughnut hole” and they then have to foot the bill for the full cost of their prescriptions until the amount reaches a so called catastrophic limit of $6,440.

However, the new doughnut hole subsidy that is now being implemented with 26 of the 71 possible drug plans will provides up to $1,200 to supplement costs of medication during the coverage gap, thus substantially helping people with paying for their prescription drugs.

 

 

 

 

More details of the Maryland Senior Prescription Drug Assistance Program include:

Premium Subsidy

The SPDAP program will pay up to $25.00 each and every month towards a member’s Medicare Rx prescription drug plan premium. However, the member needs to also be enrolled in an approved Medicare Advantage prescription drug plan or a Medicare prescription drug plan. There are over 90 different prescription benefit plans as well as Medicare Advantage drug plan options from which Maryland residents can choose from.

Coverage Gap (Doughnut Hole) Subsidy

Another component is that SPDAP will pay a prescription drug subsidy of up to $1,200 per year for members of the plan who are incurring costs while in the coverage gap or so called "doughnut hole" if the member is enrolled in a Medicare Advantage plan or a Medicare Part D plan that has agreed to administer the gap subsidy. In order for someone to take advantage of the doughnut hole subsidy, a member of the prescription drug program must be enrolled in one of the 22 participating plans that has agreed to offer the subsidy.

For more information or to apply, call the SPDAP call center at 1-800-551-5995.

By Jon McNamara

 

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