For the basic component of Maine's DEL program, state law caps what an enrollee pays for a covered drug at $2 plus 20% of the price the program allows. Its formal name is the Low Cost Drugs for the Elderly or Disabled Program, and Maine pays for it with state money. To qualify, a Maine resident must be age 62 or older, or age 19 through 61 and meet the disability criteria for Supplemental Security Income (SSI), with gross monthly income at or below 185% of the federal poverty level. DEL applies no asset test.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
In This Guide
- Key Takeaways
- What the Maine DEL Program Is
- Who Qualifies for the Maine DEL Program?
- What the Maine DEL Program Pays
- How the Maine DEL Program Works With Medicare Part D
- If You Already Have MaineCare or a Medicare Savings Program
- How to Apply for the Maine DEL Program
- Frequently Asked Questions
- Learn More
What the Maine DEL Program Is
The Low Cost Drugs for the Elderly or Disabled Program, which nearly everyone in Maine calls DEL, is run by the Maine Department of Health and Human Services under 22 M.R.S. §254-D. Its eligibility rules live in 10-144 C.M.R. Ch. 333, the DEL Eligibility Manual, amended effective October 13, 2024. The statute describes the program as providing low-cost prescription and nonprescription drugs, medication and medical supplies to disadvantaged, elderly and disabled individuals.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
The rule is direct about what DEL is not. Maine's DEL Eligibility Manual states that the program "uses state funds only and is not a Medicaid program."Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf That distinction is worth holding onto, because DEL and MaineCare are separate benefits with separate rules, and the section below on MaineCare enrollees explains where they touch.
State funding is also what gives DEL its federal standing. Under 42 CFR 423.464(e)(1), a State Pharmaceutical Assistance Program (SPAP) is a state program that helps Part D eligible people pay for drug coverage, treats every Part D plan alike, and coordinates its benefits with Part D. The same paragraph says the SPAP 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 DEL meets that test, and CMS lists the "Maine Low Cost Drugs for the Elderly or Disabled (DEL) Program" among the state pharmaceutical assistance programs excluded from Medicaid Best Price.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf Our national guide to state pharmaceutical assistance programs covers what that status buys you in general terms; the rest of this guide is Maine's version.
Who Qualifies for the Maine DEL Program?
Maine's DEL rule and statute set out the tests below. Clearing them is not the whole answer: the Part D enrollment condition covered further down can hold an otherwise-qualified Maine applicant ineligible for DEL until they comply.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
| Test | What Maine's DEL rule and statute require |
|---|---|
| Age or disability | Age 62 or older, or age 19 through 61 and meeting the disability criteria for SSI |
| Residence | Meeting the Medicaid criteria for residence in Maine |
| Income | Gross monthly income of the applicant and spouse at or below 185% of the federal poverty level, with income and exclusions counted under SSI-related rules |
| High drug spending | The monthly income limit rises by 25% if the assistance unit spends at least 40% of its gross monthly income on prescription drugs |
| Assets | No asset test, effective January 1, 2024 |
| Other coverage | Someone enrolled in Medicaid or the HIV Limited Benefit is not eligible unless also eligible for Medicare Part D, and DEL does not cover a person receiving full MaineCare pharmaceutical benefits |
Three of those rows deserve more than a table cell.
The income line is a percentage, not a dollar figure. Maine writes the DEL test as 185% of the federal poverty level, and the poverty guidelines are revised every year, so the dollar equivalent moves with them.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf For a rough sense of the neighborhood, Maine uses the same 185% line for the Qualified Medicare Beneficiary tier of its Medicare Savings Programs, and MaineCare's 2026 eligibility guidelines put that at $2,461 a month for one person and $3,337 for two.Centers for Medicare & Medicaid Services. (n.d.). Qualified Medicare Beneficiary (QMB) Program Group. cms.gov. Retrieved Jul 30, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/qualified-medicare-beneficiary-program Treat those as a yardstick rather than your DEL answer: DEL counts income under SSI-related rules, and the office that takes your application runs the calculation for your household.
The 25% bump rewards heavy drug spending. Maine raises the DEL monthly income limit by 25% for an assistance unit that spends at least 40% of its gross monthly income on prescription drugs.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf That's the rule to raise if your pharmacy costs are what put you over the line in the first place, and it's the reason someone with income above 185% of poverty should still ask rather than assume.
The asset test is gone. Maine removed it from DEL effective January 1, 2024, so savings, a car, and a home are not part of the DEL decision.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
What the Maine DEL Program Pays
Maine sets DEL's cost-sharing cap in statute, not in a fee schedule that changes quietly. For the basic component of the program, Maine's DEL statute at 22 M.R.S. §254-D provides that "the total cost to an enrollee for the purchase of any covered drug or medication may not exceed the sum of $2 plus 20% of the price allowed for that drug or medication under program rules."Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
The basic-component qualifier is the statute's own, and it points at DEL's second half: the same Maine statute makes a household with income at or below 185% of the federal poverty guideline eligible for both DEL's basic program and DEL's supplemental program.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf The ceiling above therefore governs the basic side, not the whole of what a qualifying household is eligible for.
The cap is a ceiling rather than a flat price. Which drugs DEL covers, and what price the program allows for each, are program-rule questions rather than statutory ones, so confirm your own medications with Maine's Department of Health and Human Services before you count on a number.
How the Maine DEL Program Works With Medicare Part D
DEL does not replace Medicare Part D. It sits behind it. Federal rule 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 prices and adjudicates the prescription first; the state program then helps with what you still owe.
Maine builds that order into its own eligibility rule, and this is the DEL condition people most often trip over. Someone who applies for DEL and is eligible for Medicare Part D must take action to enroll in Part D and a prescription drug plan at the next available opportunity. Someone already enrolled in DEL who later becomes eligible for Part D must enroll at the first available opportunity. A person who does not comply is ineligible for DEL until they do.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
There is a good-cause escape, and it is narrow. Maine's rule recognizes good cause when Medicare or a Part D plan denies the person enrollment because of circumstances beyond their control, or when the person has prescription drug coverage that the insurer determines is creditable coverage.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf If you think one of those applies to you, say so in writing when you apply rather than letting the file close.
Two federal advantages come with DEL's SPAP status:
- What DEL pays counts toward your Part D out-of-pocket total. 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 an enrollee's incurred costs when Medicare decides whether the annual out-of-pocket threshold has been met.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 DEL's help moves you toward the Part D out-of-pocket cap instead of being spent outside the tally. For 2025 and later years, costs reimbursed through insurance, a group health plan, or certain other third-party payment arrangements generally count toward that threshold as well. What still does not add to it is the basic prescription drug coverage your own Part D or MA-PD plan provides, 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
- You get a Part D special enrollment period, once a year. Under 42 CFR 423.38(c)(17), a person in a qualifying SPAP "is eligible to make one enrollment election per year." The special enrollment period runs while you're enrolled in the SPAP and, if you lose eligibility, for an additional two calendar months after either the month eligibility ends or the month you're notified, whichever is later.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
The election is one 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 Using it in the spring means it is gone if a plan that fits your DEL coverage better shows up in the fall.
If You Already Have MaineCare or a Medicare Savings Program
This is the part of the rule that saves people an application they don't need to file.
Effective retroactive to July 1, 2024, people enrolled in Medicaid and/or the Medicare Buy-In (Maine's Medicare Savings Program) who are eligible for Medicare Part D and meet the DEL income criteria are deemed eligible for and enrolled in DEL. They do not need to file a separate application.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
The general exclusion runs the other way and is easy to misread. Someone enrolled in Medicaid or the HIV Limited Benefit is not eligible for DEL unless they are also eligible for Medicare Part D, and DEL does not cover a person receiving full MaineCare pharmaceutical benefits.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf Put the two together and the shape is this: MaineCare alone doesn't open the DEL door; MaineCare plus Medicare Part D eligibility plus DEL's income test can, and in that case the state may already have enrolled you.
One more Maine program is worth checking if you're on Medicare. Maine's Medicare Savings Programs carry no asset test under state law, and MaineCare's 2026 guidelines list the Qualified Medicare Beneficiary tier at 185% of poverty and the Qualified Individual tier at 250%, with monthly limits of $3,325 for one person and $4,509 for two at the higher tier.Centers for Medicare & Medicaid Services. (n.d.). Qualified Medicare Beneficiary (QMB) Program Group. cms.gov. Retrieved Jul 30, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/qualified-medicare-beneficiary-program Qualifying there can carry you into DEL by the deeming rule above.
How to Apply for the Maine DEL Program
- File the form. An application for DEL coverage is made by signing the agency's application form for DEL or MaineCare.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf That form goes to the Maine Department of Health and Human Services, whose Office for Family Independence determines eligibility for MaineCare applications within 45 days.Centers for Medicare & Medicaid Services. (n.d.). Qualified Medicare Beneficiary (QMB) Program Group. cms.gov. Retrieved Jul 30, 2026, from https://www.cms.gov/medicare/medicaid-coordination/about/qualified-medicare-beneficiary-program
- Know when coverage starts. Maine starts DEL coverage on the first day of the month you file the application, or the first day of the month you meet DEL's requirements, whichever is later.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf Filing early in the month matters.
- Handle the Part D condition up front. If you're eligible for Part D, plan to enroll in Part D and a drug plan at the next available opportunity, or document your good cause.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
- Renew every year. People enrolled in DEL have their eligibility reviewed every twelve months.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf Answer the review notice when it arrives; that's the most common way coverage lapses.
Free help exists if the paperwork or the Part D piece is the obstacle. Maine's State Health Insurance Assistance Program counselors answer Medicare, MaineCare, Medigap and Part D questions and help people enroll in Medicare Savings Programs, and their services are free and confidential. Maine's statewide Aging and Disability Resource Center line, 1-877-353-3771, connects you with a local counselor.Administration for Community Living. (n.d.). State Health Insurance Assistance Program (SHIP) - Administration for Community Living. acl.gov. Retrieved Jul 30, 2026, from https://acl.gov/programs/connecting-people-services/state-health-insurance-assistance-program-ship
Not sure whether DEL or a Medicare Savings Program is the better first application? Chat with Brevy's care navigator at brevy.com.
Frequently Asked Questions
Is Maine's DEL program the same as MaineCare?
No. Maine runs DEL on state funds under its own rule, not as a Medicaid program, so the two carry separate eligibility tests and separate decisions.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf Being on one does not settle the other, and in Maine the interaction can cut against you: MaineCare membership leaves a person outside DEL unless they are also eligible for Medicare Part D.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf
Does Maine's DEL cap of $2 plus 20% apply to everything I fill?
No. That ceiling is what Maine's statute sets for DEL's basic component, and it reaches only the drugs the program covers, at the price the program allows.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf Ask Maine's Department of Health and Human Services how your own medication list prices out before you plan around a number.
I'm already on MaineCare and a Medicare Savings Program. Do I need to apply for DEL?
Probably not. Maine's deeming rule, retroactive to July 1, 2024, treats MaineCare and Medicare Buy-In members who are Part D eligible and meet DEL's income criteria as already enrolled in DEL, with no separate application.Centers for Medicare & Medicaid Services. (n.d.). State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price — CMS / Medicaid.gov. medicaid.gov. Retrieved Aug 1, 2026, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/spap-best-price-list.pdf The step that helps is asking the Office for Family Independence whether DEL already shows on your record, rather than filing a form you may not need.
Can Maine's DEL program let me switch Part D plans whenever I want?
No. DEL qualifies as a State Pharmaceutical Assistance Program, which gives you a Medicare Part D special enrollment period, but the federal rule allows one enrollment election per year, plus a two-month window after DEL eligibility ends.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
Learn More
Find personalized help sorting out Maine's DEL program and your Medicare drug coverage at brevy.com.
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.