While you may have heard of the Medicare Part D Low Income Subsidy (LIS, or "Extra Help"), there are two lesser known programs available from state governments and drug manufacturers. They are State Pharmaceutical Assistance Programs (SPAPs) and Patient Assistance Programs (PAPs). Find out more about these valuable programs designed to support those who need help the most.

What are SPAPs?

State Pharmaceutical Assistance Programs (SPAPs) are state-run programs that assist low-income older adults and people with disabilities in paying for their prescription drugs. SPAP coverage varies by state, but the programs generally provide Medicare Part D “wraparound” coverage. This means 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 Extra Help). Other states may only offer SPAPs to people 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 older adults, low-income people, and people 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. PAPs may cover the full cost of a person’s medication; in other cases, they may provide a discount. 

Arlene, in her 60s and living on a fixed income, was in extreme pain after radiation treatment for cancer. A pill form of morphine was effective in relieving her discomfort, but the medication cost several hundreds of dollars each month. 

Irene explained her situation to her doctor, who helped her apply for a drug manufacturer prescription assistance program. “The radiation nurse and I worked through the application process, and I was able to get my pain medicine free of charge for as long as I needed it,” Arlene explained.

Where can I learn more about available PAPs?

• Medicare.gov has a PAP database searchable by prescription drug name.
• Rx Assist offers a database of PAPs, searchable by drug or manufacturer name.
• NeedyMeds allows you to search for pharmaceutical assistance programs by drug name.
• Visit GoodRx, search for a medication, and look under "Ways to Save" (lower down on the page) for any available assistance programs.
• NCOA's free online BenefitsCheckUp® tool connects older adults with a variety of prescription assistance programs, including Extra Help. Users can also browse other benefits programs that can help them afford food, utilities, and more.
• You can also search for PAPs on a drug manufacturer's website.