Delaware's Prescription Assistance Program pays up to $3,000 a year toward your prescriptions and your Medicare drug plan premium. The program, DPAP for short, is open to Delaware residents 65 and older and to younger residents on disability benefits, and in 2026 it accepts monthly countable income up to $2,660 for a household of one and $3,607 for a household of two. At the counter a DPAP member pays 25% of the prescription cost or $5, whichever is greater, and the pharmacy bills Delaware for the rest.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
In This Guide
- Key Takeaways
- What the Delaware Prescription Assistance Program Pays
- Who Qualifies for the Delaware Prescription Assistance Program?
- What You Pay at the Pharmacy
- How DPAP Works With Your Medicare Part D Plan
- The One Part D Plan Change DPAP Gives You
- How to Apply for DPAP
- Frequently Asked Questions
- Learn More
What the Delaware Prescription Assistance Program Pays
The Delaware Prescription Assistance Program provides each eligible individual with up to $3,000 per year toward medically necessary prescription drugs and Medicare Part D premiums.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf That cap is statutory, not a budget guideline that shifts year to year: Title 16, Chapter 30B of the Delaware Code says payment assistance may not exceed $3,000 in a benefit year.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
Delaware pays for the program with tobacco settlement funds through the Delaware Health Fund. The Delaware State Legislature established DPAP by passing Senate Bill 6 during the 1999 legislative session; the Department of Health and Social Services (DHSS) administers the program, and the Division of Medicaid and Medical Assistance (DMMA) publishes the program page and sets the income criteria.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
Two limits are written into the Delaware statute and the DMMA program page:
- Which Part D costs count. The statute defines the "Medicare Part D costs" DPAP will help with as monthly premiums, deductibles, and drug costs falling into the Part D coverage gap, and it states that Medicare Part D costs do not include Medicare Part D co-payments.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
- Diabetic supplies. Delaware's DMMA program page states that DPAP does not pay for diabetic supplies for Medicare recipients.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
Who Qualifies for the Delaware Prescription Assistance Program?
DPAP's conditions stack, and you have to clear every one of them. You must be a Delaware resident. To qualify for Delaware's Prescription Assistance Program you must also be at least 65 years of age, or under 65 and receiving Social Security Disability benefits, which the statute frames as being aged 65 or over, or between the ages of 19 and 64 and otherwise eligible for Title II Social Security benefits. DPAP then requires that you be ineligible for Medicaid prescription benefits, and ineligible for, or not receiving, a prescription drug benefit from any other third-party payer, with Medicare Part D coverage as the one exception. Finally, you have to pass one of two money tests.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
Delaware's DPAP sets the first money test at income at or below 200% of the Federal Poverty Level. DMMA's 2026 table puts Delaware's DPAP monthly countable income limit at $2,660 for a household of one and $3,607 for a household of two.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
If your income is over DPAP's 200% FPL limit, Delaware can still approve you when your prescription costs exceed 40% of your annual income.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf That's the route for a household with a modest pension and one expensive drug, so if the pharmacy bill is what's breaking the budget, apply even when the income column says no.
| DPAP rule | |
|---|---|
| Age | 65 or older, or under 65 and receiving Social Security Disability benefits |
| Monthly countable income, household of 1 | $2,660 (200% FPL) |
| Monthly countable income, household of 2 | $3,607 (200% FPL) |
| Alternative to the income test | Prescription costs exceeding 40% of annual income |
| Other drug coverage | Must be ineligible for Medicaid prescription benefits and for any other third-party prescription benefit, other than Medicare Part D |
| Annual benefit | Up to $3,000 per eligible individual |
| Your co-payment | 25% of the prescription cost, minimum $5 |
One more DPAP condition lands after approval. If you're eligible for Medicare, you must show proof of enrollment in a Medicare Part D plan, and in Social Security's Extra Help program if you're eligible for it, within 90 days from the date your DPAP benefits begin.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf Start the Part D and Extra Help paperwork the same week you mail the DPAP application, and that clock never becomes a problem.
What You Pay at the Pharmacy
Delaware writes the DPAP co-payment into statute as a ceiling and a floor: under Title 16, Chapter 30B it may not exceed 25% of the acquisition cost, must be no lower than $5.00, and applies to prescription drug costs not covered by Medicare Part D.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf You pay that amount to the pharmacy where you fill the prescription, and the pharmacy then submits a claim and gets reimbursed by DPAP, so nothing comes back to you as a bill to chase.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
How DPAP Works With Your Medicare Part D Plan
DPAP is the program Delaware identifies to the Centers for Medicare & Medicaid Services (CMS) for coordinating benefits with Part D plans.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf That federal recognition sets the order the two payers pay in, and it changes what your DPAP dollars do for you.
Federal regulation at 42 CFR 423.464(b) states that "a Part D plan is always the primary payer relative to a State Pharmaceutical Assistance Program."U.S. Government Publishing Office. (n.d.). 42 CFR 423.464(b) — Medicare as primary payer (eCFR rolling current edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.464 Your Part D plan adjudicates each prescription first and applies its own price and cost-sharing. DPAP then wraps around what's left. So keep your Part D plan; DPAP is built to sit on top of it, not to replace it.
Money a SPAP pays on your behalf counts toward your Part D true out-of-pocket total, the running tally that decides when you hit the annual out-of-pocket threshold. The federal definition of incurred costs at 42 CFR 423.100 counts costs paid "Under State Pharmaceutical Assistance Program (as defined in § 423.464)" among your incurred costs.U.S. Government Publishing Office. (n.d.). 42 CFR 423.100 — Definitions, "Incurred costs" (eCFR, current/rolling edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.100 That same definition counts SPAP payments alongside those made by the Indian Health Service, an Indian tribe or tribal organization, an urban Indian organization, or an AIDS Drug Assistance Program.U.S. Government Publishing Office. (n.d.). 42 CFR 423.100 — Definitions, "Incurred costs" (eCFR, current/rolling edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.100 For 2025 and subsequent years the definition also counts costs reimbursed through insurance, a group health plan, or certain other third-party payment arrangements, so other coverage you hold generally moves you toward the threshold as well. The two things that still do not add to the tally are your prescription drug plan's or MA-PD plan's own basic prescription drug coverage and manufacturer payments under the Manufacturer Discount Program.U.S. Government Publishing Office. (n.d.). 42 CFR 423.100 — Definitions, "Incurred costs" (eCFR, current/rolling edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.100 So Delaware's DPAP dollars land on your annual out-of-pocket tally rather than being spent outside it. Our guide to the Medicare Part D out-of-pocket cap walks through how that threshold works.
Why does DPAP qualify at all? The funding. Federal rule at 42 CFR 423.464(e)(1) defines a State Pharmaceutical Assistance Program and states that the definition "excludes State Medicaid programs, section 1115 demonstration programs, and any other program where program funding is from Federal grants, awards, contracts, entitlement programs, or other Federal sources of funding."U.S. Government Publishing Office. (n.d.). 42 CFR 423.464(e)(1) — Coordination of benefits with other providers of prescription drug coverage (eCFR, rolling current edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.464 Delaware's tobacco settlement dollars, routed through the Delaware Health Fund, are state money, which is what the federal definition requires.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf For how this works in other states, see our national guide to state pharmaceutical assistance programs.
The One Part D Plan Change DPAP Gives You
Belonging to a qualified State Pharmaceutical Assistance Program comes with a Medicare special enrollment period (SEP) that lets you enroll in or change a Part D plan outside the usual fall window. That SPAP special enrollment period is capped at one election a year by 42 CFR 423.38(c)(17): the individual "is eligible to make one enrollment election per year."U.S. Government Publishing Office. (n.d.). 42 CFR 423.38(c)(17)(i) — Special enrollment periods, SPAP (eCFR current/rolling edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.38
If a better-priced Part D plan surfaces later in the year, this SEP will not move you a second time.
If you lose DPAP eligibility, the SEP stays open for an additional two calendar months after either the month your eligibility ends or the month you're notified, whichever is later, which gives you a short window to line up other coverage.U.S. Government Publishing Office. (n.d.). 42 CFR 423.38(c)(17)(i) — Special enrollment periods, SPAP (eCFR current/rolling edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.38
How to Apply for DPAP
DPAP is a mail-in application. You do not need to come into the DMMA office to apply.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
- Get the application. Call 1-844-245-9580 and press 0, or stay on the line, to reach a representative who can send you an application or help you fill one out. You can also print the Delaware Prescription Assistance Program application form from the DHSS site.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
- Gather your proof. You'll need proof of income and, if you're applying on the disability route, proof of your Social Security Disability benefits.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
- Sign, date, and mail it to the address printed on the form.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
- Line up Part D and Extra Help. If you're Medicare-eligible, you have 90 days from the date your DPAP benefits begin to show proof that you've enrolled in a Part D plan, and in Extra Help if you qualify.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
Not sure whether DPAP or Extra Help fits your situation first? Chat with Brevy's care navigator at brevy.com.
Frequently Asked Questions
What are the DPAP income limits for 2026?
Delaware's Prescription Assistance Program uses a 2026 monthly countable income limit of $2,660 for a household of one and $3,607 for a household of two, both set at 200% of the Federal Poverty Level.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf Countable income is what DMMA measures against its own table, so a gross figure sitting just over the line is worth submitting anyway.
Can I get DPAP if I'm under 65?
Yes, if you're receiving Social Security Disability benefits: Delaware's DPAP takes residents between the ages of 19 and 64 who are otherwise eligible for Title II Social Security benefits.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf Nothing else about the test relaxes on that route, so you still have to clear DPAP's countable-income limit and be ineligible for other drug coverage, and your application needs proof of your Social Security Disability benefits alongside your proof of income.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
Does what DPAP pays count toward my Part D out-of-pocket limit?
Yes. Delaware's DPAP is a qualified State Pharmaceutical Assistance Program, and the federal definition of incurred costs counts what a SPAP pays on your behalf among your own incurred costs, so a DPAP dollar spent at the pharmacy counter carries you toward Medicare's annual out-of-pocket threshold exactly as a dollar from your wallet would.U.S. Government Publishing Office. (n.d.). 42 CFR 423.100 — Definitions, "Incurred costs" (eCFR, current/rolling edition). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/section-423.100
Is DPAP the same as Delaware's PACE program?
No. DPAP is a prescription payment assistance program. Delaware's Program of All-Inclusive Care for the Elderly is a separate program providing full medical and long-term care,Centers for Medicare & Medicaid Services. (n.d.). PACE — Medicare.gov. medicare.gov. Retrieved Jul 13, 2026, from https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE and DHSS also runs a Chronic Renal Disease Program that is distinct from DPAP.Centers for Medicare & Medicaid Services. (n.d.). SPAP Contact List: Programs that Want to be Identified for Purposes of Coordinating Benefits with Part D Plans — CMS. cms.gov. Retrieved Aug 1, 2026, from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/downloads/spapcontactlist.pdf
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.