Home care: Where to find It
Low Cost Drugs for the Elderly and Disabled Program
Maine’s Low Cost Drugs for the Elderly and Disabled Program helps to pay for prescription drugs for people whose income is no more than 185% of the federal poverty level. You must be age 62 or older; or age 19 or older and medically qualified for Social Security Disability Income (SSDI). If you spend more than 40% of your income on prescription drugs, the income level increases.
- 80% minus $2.00 of the cost of all generic prescription drugs on the Preferred Drug List.
- 80% minus $2.00 of the cost of brand-name medications on the Preferred Drug List 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).
The Supplemental benefit includes other drugs not covered in the Basic Benefit. The drugs must be medically necessary and supplied from participating manufacturers. Actual savings vary from drug to drug. DEL Members pay the State’s negotiated MaineCare rate minus $2.00.
Catastrophic Spending Limit:
After a Member spends $1,000 on eligible prescription drugs, the State pays 80% of the cost of all eligible prescription drugs, regardless of any disease or condition. The drugs must be medically necessary and supplied from companies with agreements with the State. Eligible prescription drugs are only those drugs that were covered by DEL on May 31, 2001. The Catastrophic Spending Limit is tracked from August 1st each year to July 31st of the following year.
- Some drugs require ‘prior approval’ for coverage.
- Coverage through DEL is funding of last report. Members with other prescription drug coverage must use those benefits first.
- Members with Medicare Part D coverage are eligible for DEL Wrap benefits only.
- The DEL PDL is posted at http://www.mainecarepdl.org/pdl
Mainers of all ages with income under 350% of the federal povery level may be eligible for prescription
drug discounts through the Maine Rx Plus Program. The program provides discounts of 15%
- 60% off retail prices for drugs on the MaineCare Preferred Drug List. The greatest savings
are on generic drugs.
To request an application or for more information about the medications covered in the Low Cost Drugs for the
Elderly & Disabled or the Maine Rx Plus Program, call:
- Toll free: 1-866-796-2463
- TTY: 207-287-1828 or 1-800-423-4331
Your local Area Agency on Aging can tell you the current income guidelines and help you to apply.
- Call your local Area Agency on Aging at 1-877-353-3771.