State Pharmaceutical Assistance Programs are state sponsored programs that help specific groups of people such as the elderly and disabled access prescription medications. SPAP program coverage varies from State to State. Ramsell Public Health Rx administers SPAP’s that provide wrap-around coverage to its members who enroll in a Medicare Part D Prescription drug plan. This can include coverage of premiums, deductibles, copays/coinsurance, coverage gap (commonly referred to as the “doughnut hole”) as well as coverage during the catastrophic coverage. SPAP’s contribute to cost-sharing that will count towards the beneficiary’s true-out-of-pocket expenditures (TrOOP).
The Bridging the Gap Colorado (BTGC) Program covers the costs of a program member’s Medicare Part D Plan deductible, co-payments, co-insurance, and costs incurred while in the coverage gap, ensuring the appropriate transition of the member, to the Medicare Part D plan catastrophic coverage level. Once the catastrophic coverage level is reached, BTGC pays the (up to 5% of the cost of a medication) co-payment on those medications that are on the AIDS Drug Assistance Program formulary only (see formulary link below) for the remainder of the Prescription Drug Plan benefit year. The member must pay for any other medication’s catastrophic level co-payment himself or herself.
In addition, BTGC may pay program member’s Medicare Part D Prescription Drug Plan premiums if appropriate payment information is provided to enrollment staff at the Colorado Department of Public Health and Environment.,
Any individual that qualifies for the Colorado AIDS Drug Assistance Program (ADAP) and is eligible for Medicare Part Dmay receive assistance from the BTGC Program, but must complete both the ADAP and BTGC applications to enroll. You may find these applications on the website link below. Enrollment in the BTGC Program will be conducted by the Colorado Department of Public Health and Environment. Upon enrollment, BTCG members will be issued ID cards to identify program eligibility. Participants must fill their prescription at a pharmacy that participates in the BTGC program.
There is no set formulary for the Bridging the Gap program prior to the catastrophic coverage level. Members have access to the medications on the formulary of the Medicare Part D plan in which they have enrolled.
Todd Grove
Bridging the Gap, Colorado-3835
4300 Cherry Creek Dr. South
Denver, CO 80246-1530
Phone: 303-692-2783
Fax: 303-782-5393
Website: Bridging the Gap, Colorado
Website: Colorado AIDS Drug Assistance Program
Our Heart is in Public Health
Oakland, Calif., February 1, 2009 - Ramsell Public Health Rx, a pharmacy benefit and information management company, announced the availability of its 340B Contract Pharmacy Management Solution, a comprehensive offering that streamlines the administration and management of the delivery of pharmacy services for 340B covered entities. Ramsell is launching the new solution at the 340B Coalition Winter Conference in San Francisco today.