Programs in Maryland to lower prescription costs, from statewide options to a free discount card
Maryland residents have several ways to lower the cost of prescription medication, and the right one depends mostly on your insurance situation. This is a plain-English guide to the programs available. People on Medicare have the state's own SPDAP subsidy and the federal Extra Help program. People with low incomes can get prescriptions covered through Maryland Medical Assistance. Anyone, insured or not, can use the free Maryland Rx Card or order low-cost generics from a nonprofit pharmacy that works with the state, and separate state programs exist for kidney disease, HIV, and insulin.
None of these programs charge a fee to apply, and free help exists for every one of them, so nobody should be paying anyone to enroll them. This page explains each option, who it is for, and how to apply or where to call.
SPDAP for Maryland residents on Medicare
The Senior Prescription Drug Assistance Program, or SPDAP, pays part of the monthly premium for a Medicare Part D plan or a Medicare Advantage plan with drug coverage. The state sets a maximum monthly amount each year, and the current figure and the list of participating plans are posted at https://marylandspdap.com/spdap-you-4/spdap-subsidies-2/. The money is paid directly to your plan, so your premium bill is lower or, for some members, covered in full. SPDAP was created by the Maryland General Assembly in 2005 and is overseen by the Maryland Department of Health, and while the amount can change with the state budget and no program is guaranteed forever, it has run continuously since then.
You qualify if you have lived in Maryland for at least six months, you are on Medicare, and your income is at or below 300 percent of the federal poverty level, which is a higher limit than most assistance programs use. The test is income only, with no asset limit, so savings or a home do not count against you. You cannot get SPDAP if you are on Maryland Medical Assistance, if you have drug coverage through another health plan such as a retiree plan, or in most cases if you already receive the full federal Extra Help subsidy, since that already pays the premium. If you are married, both you and your spouse can receive the subsidy, but each of you must sign the application.
To apply: Download the application at https://marylandspdap.com/how-to-apply-2/ or call 1-800-551-5995 (Monday through Friday, 8 a.m. to 5 p.m., TTY 1-800-877-5156) to have one mailed to you, and apply as early as you can because processing takes time. One instruction from the program is easy to miss: do not have your drug plan premium deducted from your Social Security check, because SPDAP pays the plan directly and asks members to request direct billing from their plan instead. Members also get one extra drug plan change per year on top of the regular fall open enrollment period.
Extra Help and Medicare Savings Programs for lower incomes
If your income is below the SPDAP range, the federal Extra Help program is the better fit. It covers most Medicare drug costs for people with limited income and resources, paying the plan premium and the deductible and leaving only a small copay per prescription. The federal government sets and updates the income and resource limits each year, and the current figures are at https://www.medicare.gov/basics/costs/help/drug-costs. Apply through Social Security at 1-800-772-1213, or read our guide to Extra Help, the Medicare program that lowers prescription drug costs for low-income people, which walks through the application.
Maryland's Medicare Savings Programs pay the Part B premium for people with limited income, and the QMB level of the program also covers Medicare deductibles and copays. Enrollment runs through Maryland Medical Assistance, and getting into any Medicare Savings Program qualifies you for Extra Help automatically, so one application can lower both your medical and drug costs. The Maryland Department of Aging explains the programs at https://aging.maryland.gov/programs-and-services/medicare-support/medicare-savings-programs.
Maryland Medical Assistance covers prescriptions for low-income residents
Maryland calls its Medicaid program Medical Assistance, so both names refer to the same coverage. If you qualify, your managed care organization covers prescription drugs along with doctor visits and hospital care at no cost, and you can enroll at any time of year rather than waiting for an open enrollment period. The Maryland Children's Health Program covers children up to age 19 in families who earn too much for Medical Assistance.
Apply through Maryland Health Connection at https://www.marylandhealthconnection.gov/how-to-enroll/medicaid/, by phone at 1-855-642-8572, or by paper application on request, and free in-person help is available across the state for anyone who wants it. If you are on Medicare and your income is very low, you may qualify for Medical Assistance alongside Medicare, which lowers drug costs further than either program alone.
The Maryland Rx Card, a free discount card for any resident
The Maryland Rx Card is a free prescription discount card available to every Maryland resident with no enrollment, no income limit, and no forms. You print, text, or email a card to yourself from https://marylandrxcard.com/about and show it at the pharmacy, and it is accepted at most chain and independent pharmacies. The discount varies by drug and by pharmacy, so it is worth asking the pharmacist to compare the card price against your insurance copay or the cash price.
Be clear about what it is. The card is a privately supported discount program, not a state agency benefit and not insurance, though 211 Maryland lists it as a resource for residents. It works instead of your insurance on a given fill when its price is lower, or for drugs your plan does not cover, and it cannot be combined with insurance on the same purchase. Our guide to free prescription drug discount cards and apps explains how these programs make money and when they help.
Good Pill, a nonprofit pharmacy working with the state
Good Pill is a nonprofit home-delivery pharmacy that works in partnership with the State of Maryland and fills its stocked generic medications for a small flat fee per prescription, with free shipping and no income test. Stock is limited to the medications listed on its site, and it does not carry insulin or test strips, so check availability at https://goodpill.org/gp-stock/ or call (888) 987-5187 before counting on it. For someone taking common generic maintenance drugs without coverage, it is often the cheapest option available.
State programs for specific conditions
The Maryland Kidney Disease Program helps certified Maryland residents with end-stage renal disease pay for dialysis-related care, and it covers prescription drugs on its reimbursable drug list, including the anti-rejection medications transplant patients must take for life. It is a payer of last resort, meaning it pays after Medicare and other coverage, and it can cover the Medicare deductible and coinsurance that remain. The program has operated through the Maryland Department of Health since 1971; details and certification information are at https://health.maryland.gov/pha/Pages/maryland-kidney-disease-program.aspx, or email [email protected].
Maryland's AIDS Drug Assistance Program, known as MADAP, is the state's version of the federal ADAP program for people with HIV. Our page on help paying for HIV medication through the AIDS Drug Assistance Program covers how ADAP works, who qualifies, and the drug company programs that fill the gaps.
For insulin, Maryland law caps the monthly copay on state-regulated commercial insurance plans, though the cap does not apply to large self-funded employer plans or to people without insurance, and Medicare has its own federal cap. If you are uninsured or your plan is not covered by the state cap, see our guide to free and low cost insulin through patient assistance programs and other options.
Free help choosing and applying
If you are on Medicare, Maryland's State Health Insurance Assistance Program, known as SHIP, offers free counseling from trained volunteers who do not sell insurance and work through the Department of Aging and the local Area Agencies on Aging. A SHIP counselor can screen you for SPDAP, Extra Help, and the Medicare Savings Programs, help you complete the applications, and compare drug plans with you. Find a counselor at https://aging.maryland.gov/programs-and-services/medicare-support/state-health-insurance-assistance-program or through the Department of Aging at 1-800-243-3425, and our page on Maryland Agency on Aging senior assistance programs covers the other services your local office provides.
For a one-time emergency, some local churches and nonprofits in Maryland help pay for a specific prescription, and 211 Maryland keeps a searchable list of them along with the programs above at https://211md.org/resources/health-care/prescriptions. Dialing 211 reaches a specialist who can search by county.
A note on this information
NeedHelpPayingBills.com provides information on assistance programs and general resources only, not medical or insurance advice. Questions about your medications belong with your doctor or pharmacist, and a SHIP counselor or Maryland Health Connection navigator is the right person to review your coverage.
Subsidy amounts, income limits, and program rules are set by the state, the federal government, and each organization, and they change over time. Confirm current figures with the program before you apply
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