Some state governments and drug manufacturers offer lesser known programs that can help older adults afford their medications.
Roughly half of all states have a State Pharmaceutical Assistance Programs (SPAPs), and drug manufacturers offer Patient Assistance Programs (PAPs) to help people pay for brand-name medications.
There are benefit counselors who can help low-income seniors and persons with disabilities get helpful tips on assisting clients with these programs.
Medicare Part D is the prescription drug coverage available to people with Medicare who have Medicare Part A and/or Part B and live in a Part D plan's service area. Check with Medicare regarding plan benefits, private plans approved by them, costs and drugs covered, prescription coverage and enrollment.
What are SPAPs?
State Pharmaceutical Assistance Programs (SPAPs) are state-run, federally funded programs to provide free, objective assistance to people with Medicare and their families. These programs generally provide Part D "wraparound" coverage where they pay costs that Medicare Part D does not pay.
Our state health insurance program is through "Georgia SHIP". It provides the following:
a. Free counseling services
b. Certified counselors who can help with Medicare:
Understand your health plan choices
Enroll in a Medicare plan that meets your needs
Review Medicare Summary Notice (s)
Review explanation of benefits
Sort through medical bills, assist with filing Medicare claims and appeals
Help apply for financial assistance programs to reduce Medicare out of pocket expenses
If you are an older adult who needs assistance exploring your Medicare drug coverage and options, use these resources:
To get help with our local State Health Insurance Assistance Program (SHIP) contact the
Department of Human Services Division of Aging Services:
(Georgia SHIP): Georgia State Health Insurance Assistance Program:
Call 866-552-4464, select option 4
National Council on Aging Benefits Checkup: https://benefitscheckup.org/
This site is an online tool connecting older adults and people with disabilities to benefits allowing you to determine whether you can get help for programs such as Supplemental Nutrition Assistance Program (SNAP), Medicare Savings Program, Medicaid, Medicare Part D Low Income Subsidy (LIS) - Extra Help and others, before you apply.
Contact their helpline at 1-800-794-6559, Monday through Friday, 9 a.m. to 5 p.m. EST.
SHIP: State Health Insurance Assistance Center
National Technical Assistance Center: https://www.shiphelp.org/
Additional Resources:
Medicare and you Handbook:https://www.medicare.gov/publications/10050-Medicare-and-You.pdf
Medicare Advantage Part C & Part D Payment Policies: https://www.cms.gov/files/document/2023-announcement.pdf
What are PAPs?
Patient Assistance Programs (PAPs) are offered by some drug manufacturers to help older adults, low income individuals, and people with disabilities pay for pharmaceuticals.
Medicare.gov has a PAP database searchable to find a Pharmaceutical Assistance program for your prescription or drugs you take.
RX Assist has a database of PAPs, searchable by drug or manufacturer name
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