State Pharmaceutical Assistance Program: Washington

Not all Medicare beneficiaries are able to pay for their monthly medications and bills. They don’t have the income they need to manage the constantly rising cost of their medications and maintaining their homes. Because of this, many Medicare beneficiaries are looking for help to pay for their medications. Most are surprised to find their state offers help in the form of state pharmaceutical assistance programs.

State pharmaceutical assistance programs, SPAPs, are available in some states. These programs are available to those that meet a certain set of criteria and provide a huge help to those that qualify. Not all states are able to fund these programs so they aren’t available nationwide. The states that do offer these programs have worked hard with their legislatures and government bodies to find the funding, providing the relief their residents desperately need.

Washington is one of the states that offers a state pharmaceutical assistance program.

Washington State Health Insurance Pool

Washington State offers its residents help with medication needs. Those that are interested in the Washington State Health Insurance Pool can call 800-877-5187 for more information.

Eligibility Requirements

Those that are interested in the program have to meet the following criteria:

Those with Medicare:

  • Must be a Washington state resident
  • Must have Medicare Part A and Medicare Part B
  • Must have a rejection letter from a Medicare Supplemental Insurance Policy (rejection must be because of medical reasons, a requirement of restrictive riders, up-rated premium or a limitation due to preexisting conditions)
  • Must not have a comprehensive Medicare supplemental coverage available
  • Cannot have reasonable access to or a reasonable choice of Medicare Advantage Plans (Medicare Part C)

Those WITHOUT Medicare:

  • Must be a Washington state resident
  • Must have been rejected for insurance coverage by an insurance provider because of the results of a Standard Health Questionnaire or live in a Washington county that doesn’t offer individual health benefit plans
  • Must not be eligible for Medicare coverage

Who to Contact

Those that meet the eligibility requirements can send their information and applications to:

PO Box 1090

Great Bend, KS. 67530

What are the Benefits

Those that apply for and are approved for help from the Washington State Health Insurance Pool will enjoy the following benefits:

The program will pay for eligible expenses as a secondary insurance provider, assuming expenses that patients would be responsible for. While this plan doesn’t directly help with medications that are normally covered under Medicare Part D prescription drug plans, it is a program that helps with medications covered under Medicare Part B and supplemental medication coverage.

Those that need more help than the Washington State Health Insurance Pool can provide should contact the Social Security Administration. The Social Security Administration offers a nationwide assistance program called the Low Income Subsidy Program. This program can be used by anyone that is eligible. To apply, those interested should call the Social Security Administration at 800-772-1213.

There are many Medicare beneficiaries that struggle with the cost of their medications each month. This is a struggle that can be eliminated with the assistance of a state pharmaceutical assistance program.

Mar. 20 14'

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