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SPAP basics

SPAP basics

Many states offer State Pharmaceutical Assistance Programs (SPAPs) to help residents pay for prescription drugs. Each program works differently.

States may coordinate their drug assistance programs with Medicare’s prescription drug benefit (Part D). Some SPAPs require that you sign up for Part D in order to qualify for assistance. In these cases, if a drug is covered by both your SPAP and your Part D plan, both the amount you pay for your prescriptions plus the amount the SPAP pays will count toward the out-of-pocket maximum you have to pay before reaching catastrophic coverage. Many SPAPs continue providing coverage during your Part D plan’s coverage gap.

Your SPAP may also help pay for your Part D plan’s:

  • Premium
  • Deductible
  • Copayments

Certain states have qualified SPAPs. Qualified SPAPs provide a Special Enrollment Period (SEP) to allow you to enroll in or make changes to your Part D or Medicare Advantage coverage.

Check our list of State Pharmaceutical Assistance Programs to find out if your state has an SPAP, whether you are eligible, how the SPAP works, and how to enroll.