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Texas HIV SPAP

The Texas HIV Medication Program (THMP) runs an HIV State Pharmaceutical Assistance Program (SPAP), which began operating on January 1, 2008. The Texas SPAP was developed to help HIV-positive individuals with their out-of-pocket costs associated with Medicare Part D prescription drug plans, including co-payments, deductibles, coinsurance, and during the coverage gap (the "donut hole").

Frequently Asked Questions

What is SPAP?

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 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).

What is the Texas HIV SPAP Program?

The Texas SPAP program is designed to assist Texas HIV Medication Program (THMP) members eligible for Medicare Part D Drug benefits. Members must enroll in a Medicare Part D Plan and will receive assistance through the Texas HIV SPAP with out-of-pocket medication costs associated with Medicare Part D prescription drug plans. Assistance will be provided until the member reaches the Texas HIV SPAP maximum benefit allowance. Medicare Part D is a tiered benefit that requires program members to satisfy expenditure requirements, called True-Out-of-Pocket costs (TrOOP), in order to move through the tiers and reach the maximum coverage level, termed catastrophic coverage. Costs incurred by the SPAP will count toward a member's TrOOP, thereby allowing the member to reach the catastrophic coverage level faster and resulting in lower prescription co-payments. This, in turn, should increase the number of Texans who receive needed HIV medications.

Am I Eligilbe for Texas HIV SPAP?

Eligilble members must meet the THMP requirements of being a Texas resident, HIV positive and have an income at or below the Federal Poverty Level of 200%. Additonally, members must be elgible for Medicare Parts A and/or B. enrolled into a Medicare Part D Prescription Drug Plan, and denied the Low Income Subsidy through the Social Security administration or approved for partial subsidy. A complete copy of the letter is required.

How Do I Enroll in the Texas HIV SPAP?

Submit the Texas HIV SPAP enrollment form listed below, to the THMP. On the application you will need to provide your Medicare Part D plan information and your Low Income Subsidy (LIS) status. Please note that the Texas HIV SPAP will require a complete copy of your LIS approval or denial letter before your SPAP enrollment will be complete. If you are not currently enrolled in the THMP you will also need to submit a complete THMP application. Once your enrollment is complete you will get an enrollment packet from our contractor, Ramsell, which will include a SPAP identification (ID) card.

  HIV SPAP Application Form click to download
  Application for Medication Assistance click to download
  Solicitud de Asistencia de Medicación click to download

What Drugs Are Covered?

Currently, the Texas HIV SPAP will pay the copayments for all of your medications on your Medicare Part D formulary. Changes may occur based on funding.

Where Can I Fill Prescriptions?

You can fill your prescriptions through any one of the participating pharmacies in your the state of Texas.

To locate the pharmacy closest to you, use the Pharmacy Locator on the left panel, or call Ramsell at 1-888-311-7632.

To process your medications the pharmacist will need your SPAP ID card, Medicare Part D Plan information and valid prescriptions.

Where Can I Get More Information About the Program?

For more information and questions on program enrollment, please contact:

Texas HIV State Pharmaceutical Assistance Program (SPAP)
Phone Number: 1-800-255-1090
Fax: 512-533-3178
Website: The Texas HIV Medication Program

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