Title 16
30000DELAWARE PRESCRIPTION ASSISTANCE PROGRAM
DELAWARE PRESCRIPTION ASSISTANCE PROGRAM
30000 Delaware Prescription Assistance Program
30100 Definitions
30200 General Application Information
30201 Disposition of Applications
30202 Timely Determination of Eligibility
30203 Reporting Changes in Circumstances
30300 Technical Eligibility
30301 Citizenship and Alienage
30302 State Residency
30303 Social Security Number
30304 Aged or Disabled Requirement
30305 No Other Prescription Drug Coverage
30305.1 Exceptions to No Other Prescription Drug Coverage
30306 Inmate of a Public Institution
30400 Financial Eligibility
30401 Countable Income
30402 Excluded Income
30403 Eligibility Determination
30404 Effective Date of Coverage
30405 Redetermination of Eligibility
30500 Benefits
30501 Limitations on Benefits
30502 Co-payment Requirement
30503 Waiver of Co-payment for Good Cause
30600 Confidentiality
30601 Release of Information to DPAP Providers
30602 Release of Information to Others
30700 Fair Hearings
The 140th General Assembly amended Title 16, Delaware Code, by adding Chapter 30B to enact the Delaware Prescription Drug Payment Assistance Program. The purpose of this act is to provide payment assistance for prescription drugs and certain Medicare Part D costs to low-income seniors and individuals with disabilities who are ineligible for, or do not have, prescription drug benefits or coverage through federal (excluding Medicare Part D coverage), state, or private sources
The program is administered by the Fiscal Agent under contract with the Delaware Department of Health and Social Services.
The rules in this section set forth the eligibility requirements for coverage under the Delaware Prescription Assistance Program (DPAP). The DPAP is implemented January 1, 2000, with benefits beginning January 14, 2000.
9 DE Reg. 774 (11/01/05)
Contractor: the agent who is under contract with the State to administer the DPAP.
Department: the Department of Health and Social Services or DHSS
Division: the Division of Medicaid & Medical Assistance or DMMA
Low Income Subsidy (LIS): Assistance provided by the Centers for Medicare and Medicaid Services to pay Medicare Part D costs for individuals with limited income and resources. The LIS will provide payment assistance with the monthly premium, the yearly deductible, and the coverage gap. The LIS will also provide payment assistance for co-payments after an individual with income below 135% of the Federal Poverty Level reaches a total of $5100 in drug expenses.
Medicare Part D: The Medicare Prescription Drug Program established by the Medicare Prescription Drug, Improvement and Modernization Act of 2003.
Medicare Part D costs: monthly premiums, yearly deductible, and drug costs that fall into the Part D coverage gap.
9 DE Reg. 774 (11/01/05)
