Colorado SPAP – Bridging the Gap
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 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. Prescription co-payments and co-insurance amounts are not covered once the program member reaches the catastrophic coverage level. This allows the greatest prescription coverage while maintaining the lowest financial burden to the patient. Premium assistance is available through the Colorado AIDS Project (CAP).
Any individual that qualifies for the AIDS Drug Assistance Program (ADAP) and is eligible for Medicare Part D, may receive assistance from the Bridging the Gap, Colorado program and must complete the enrollment form to receive this eligibility. Enrollment into the Bridging the Gap, Colorado program will be conducted by the Colorado Department of Public Health and Environment. Upon enrollment, Bridging the Gap members will be issued ID cards to identify program eligibility.
There is no formulary for the Bridging the Gap program. Members have access to the medications on the formulary of the Medicare Part D plan in which they have enrolled.
CDPHE
Bridging the Gap, Colorado -38354300
Cherry Creek Dr. South
Denver, CO 80246 -1530
Phone: 303-692-2783
Fax: 303-782-5393
Oakland, Calif., May 12, 2008 - Ramsell Public Health Rx today announced that it will administer a full suite of Pharmacy Benefit Management (PBM) solutions for the Bridging the Gap, Colorado (BTGC) program, a State Pharmaceutical Assistance Program (SPAP) that covers the costs of a participant’s Medicare deductible, co-payment and coinsurance. The customizable PBM solution will provide a comprehensive package to meet BTGC’s service needs, including coordination of benefits, claims adjudication, pharmacy network management and data management.