Roughly half of all states have a State Pharmaceutical Assistance Programs (SPAPs) to help older adults afford medication.
Patient Assistance Programs (PAPs) are offered by drug manufacturers to help people pay for brand-name medications.
Benefits counselors who assist low-income seniors and persons with disabilities can get helpful tips on assisting clients with these programs.
Two lesser known programs that can help older adults afford their medications are available from state governments and drug manufacturers.
What are SPAPs?
State Pharmaceutical Assistance Programs (SPAPs) are state-run programs that assist low-income seniors and adults with disabilities in paying for their prescription drugs. SPAP coverage varies by state, but the programs generally provide Part D “wraparound” coverage, meaning that they pay costs that Medicare Part D does not pay.
Does every state have an SPAP?
No. Fewer than half of all states have an SPAP. To find out if one is available in your area, visit Medicare.gov and select your state from the drop-down menu.
Who can apply for an SPAP?
Eligibility rules vary by state. Some states require applicants to be enrolled in Medicare and unable to qualify for the Part D Low Income Subsidy (LIS/Extra Help). Other states may only offer SPAPs to individuals with certain chronic conditions, such as those who are HIV+.
What are PAPs?
Patient Assistance Programs (PAPs) are offered by some drug manufacturers to help seniors, low-income individuals, and persons with disabilities pay for pharmaceuticals.
Who can apply for a PAP?
Program eligibility guidelines vary. Some PAPs offer limited supplies of free prescriptions to anyone with demonstrated financial need; other programs are limited to those who lack any type of insurance, or whose prescription drug coverage does not cover the medication being requested.
Where can I find more about available PAPs?
Medicare.gov maintains a PAP database searchable by your prescription drug name.
Rx Assist offers a database of PAPs, searchable by drug or manufacturer name.
NCOA's free online tool, BenefitsCheckUp®, screens for a variety of prescription assistance programs, including the Part D Low Income Subsidy (LIS/Extra Help).
You can also search specifically on the website of the drug manufacturer.