State Pharmaceutical Assistance Program: Maine

As the cost of medications increase, most Medicare beneficiaries wonder how they are going to continue to pay for their medications and their Medicare part D prescription drug plan. Not all Medicare beneficiaries have the income necessary to pay for a lot of medications as well as their other bills. Because millions of seniors are in this position, there are some assistance programs available. Although these programs are available, not all Medicare beneficiaries know where to find it.

The first place that most Medicare beneficiaries look to for help is the federal government. They don’t realize that some states have assistance programs in place to help them pay for their medication needs. The states that offer assistance programs often offer state pharmaceutical assistance programs, SPAPs. These programs vary from state to state but the benefits are more than most people realized.

Maine is a state that offers its residents help with a state pharmaceutical assistance program.

Maine Low Cost Drugs for the Elderly or Disabled Program

The Maine Low Cost Drugs for the Elderly or Disabled Program is the SPAP for Maine. Those that are not residents of Maine should not apply for this program. Those that are residents and interested in applying for or getting more information should call 1-866-796-2463.

Eligibility Requirements

Those that are interested in this program should know there are eligibility requirements that have to be met. Those that want to apply should meet the following requirements:

·         Must be a Maine resident

·         Income can NOT be more than 175% of the federal poverty level

·         Must be 62 and older OR 19 and older and medically qualified for Social Security Disability Income

*Those that spend more than 40% of their income on prescription medications will see the income levels increase.

Who to Contact

Those that are interested in applying should contact:

Office of MaineCare Services

242 State Street

Augusta, Me. 04333

What are the Benefits?

Those that apply for and are approved for the Maine Low Cost Drugs for the Elderly and Disabled Program find there are a lot of benefits.

·         80% minus $2 of the cost of all generic medications on the preferred drug list will be paid

·         80% minus $20 of the cost of brand named medications of the preferred drug list will be paid (for the treatment of: diabetes, heart disease, high blood pressure, chronic lung disease [emphysema and asthma], arthritis, anticoagulation, Hyperlipidemia [high cholesterol], incontinence, thyroid disease, osteoporosis, [bone density loss], Parkinson’s Disease, glaucoma, Multiple Sclerosis and ALS [Lou Gehrig’s disease])

·         *drugs that aren’t covered under the basic benefit and are medically necessary can be supplemented by the participating manufacturers. Members will pay the state’s negotiated MaineCare rate minus $2

·         Once a member pays $1,000 on eligible medications, the state will pay 80% of the cost of prescriptions  that are eligible, no matter the disease or condition it is needed for *contact the SPAP for further explanation of this benefit

Those that would like to apply for this program should do it as soon as possible. Those that don’t qualify for this program should look for other assistance programs. The Social Security Administration sponsors the Low Income Subsidy program. Those that would like help should call and apply.

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