A state funded program that helps pay for prescription drugs and Over the Counter drugs for people who meet certain conditions.
What Are the Financial Eligibility Limits for the Program?
Income Test: Must Be Below 175% of the Federal Poverty Limit for your family size.
Asset Test: Liquid Assets Must Be Below $50,000/$75,000 for single/couple. Non-Liquid Assets Do Not Count: e.g. house, vehicles, income producing property, savings of $8000/$12,000, tools of the trade, furniture.
Who Is Eligible for Del?
Must be age 62 or disabled. (Use Social Security definition of disabled.)
What Does DEL Cover?
Basic Coverage: DEL covers prescription brand name and generic drugs for 13 listed conditions: heart disease, diabetes, high blood pressure, arthritis, chronic lung disease (including emphysema and asthma), anticoagulation, hyperlipidemia (high cholesterol), incontinence, thyroid disease, osteoporosis (bone density loss), Parkinson's disease, glaucoma, and multiple sclerosis/ amyotrophic lateral sclerosis (Lou Gehrig’s Disease)
Supplemental Coverage: DEL covers some drugs for non-listed conditions.
The list of covered drugs can be found at http://mainecarepdl.org/pdl. (Restrictions, e.g. prior authorization, step-therapy, etc. may apply.)
How Much Does DEL Pay?
DEL will pay 80% of the cost of the drug, after the recipient first pays $2.00, plus 20% of the cost.
If I Have DEL and Medicare Part D, Can DEL Help Me?
Yes. For MaineCare Members who have full MaineCare (not just MSP), DEL can help reduce your Medicare Part D drug co-payment to $0 for generics and to $1.80 for brand-name drugs.