Maryland SPDAP pays up to $100 a month toward your Medicare Part D or Medicare Advantage drug plan premium in 2026, if you aren't eligible for full federal Extra Help. The Senior Prescription Drug Assistance Program, overseen by the Maryland Department of Health, sets a 2026 household income ceiling of $47,880 for one person and $64,920 for two, and it's built for Maryland residents already enrolled in a Medicare drug plan. Income is one of five eligibility conditions, and enrollment is capped.

In This Guide

What Maryland SPDAP Is and Who Runs It

SPDAP stands for the Senior Prescription Drug Assistance Program, and it is Maryland's State Pharmaceutical Assistance Program. The Maryland General Assembly created it in 2005. The Maryland Department of Health (MDH) oversees it and is required to report on it every year to the Governor and the General Assembly under Health-General §15-1005(a). MDH contracts the day-to-day operation out to a third-party administrator, and effective May 1, 2021 that administrator is International Software Systems, Inc. (ISSI).

The eligibility rules are codified in the Code of Maryland Regulations at COMAR 10.09.60, Chapter 60, Senior Prescription Drug Assistance Program. The Maryland Insurance Administration reports that Senate Bill 219 extends Maryland SPDAP to December 31, 2030, so this is not a benefit scheduled to lapse next year.

The "State Pharmaceutical Assistance Program" label is a federal term of art. Federal regulation at 42 CFR 423.464(e)(1) defines a State Pharmaceutical Assistance Program (SPAP) as a state program that helps Part D eligible people buy supplemental drug coverage, treats every Part D plan alike rather than steering members toward one, coordinates its benefits with Part D, leaves the primary payer unchanged, sets eligibility on financial need, age, or medical condition rather than employment, and does not engage in midyear or noncalendar-year plan enrollment changes on behalf of a substantial number of its members. The same paragraph excludes state Medicaid programs, section 1115 demonstration programs, and any program funded from federal grants or other federal sources. That is the test that separates a senior Part D wraparound like SPDAP from federally funded drug programs that borrow the same acronym. Our national guide to state pharmaceutical assistance programs goes deeper.

What Maryland SPDAP Pays

For 2026, the Maryland SPDAP program site, which ISSI runs as MDH's contracted administrator, states that SPDAP will pay up to $100.00 per month toward the premium of an approved Medicare Part D prescription drug plan or Medicare Advantage plan.

MDH resets the maximum monthly subsidy each calendar year. The amounts on record since 2023 are below.

Program year Maximum monthly premium subsidy
2023 $60
2024 $75
2026 $100.00

Those are the published amounts, not a complete year-by-year series. The 2026 figure comes from the administrator's program site; read it off the current year's enrollment application before you budget on it.

What SPDAP won't do is help at the pharmacy counter. The Maryland Insurance Administration describes SPDAP as a premium subsidy only program that does not help with out-of-pocket drug costs. So if the number hurting you is a specialty-tier copay, look at federal Extra Help first.

Who Qualifies for SPDAP in Maryland?

COMAR 10.09.60.02 sets five conditions. To be eligible for enrollment, an individual shall:

  1. Be a resident of Maryland. The enrollment application goes further and requires established residency in the state for a minimum of six months before your application date.
  2. Be a Medicare beneficiary enrolled in a drug plan, either a Medicare Part D plan or a Medicare Advantage plan that provides Part D coverage. SPDAP subsidizes a premium you already owe, so you sign up for drug coverage first and SPDAP second.
  3. Have annual household income at or below 300 percent of the federal poverty guidelines for your household size. The enrollment application defines the term it is testing: "Household Income means the earned and unearned income of the applicant and spouse who reside in the same residence. If you filed a federal income tax return, household income includes both taxable and non-taxable income (i.e., Social Security, etc.)" So the definition reaches two people, you and a spouse sharing your residence, and it counts non-taxable income such as Social Security, the item applicants most often leave out of the total. What the regulation counts is narrower in one direction and wider in another; see "What counts as household income" below.
  4. Not be enrolled in other prescription drug coverage, meaning a health benefit plan other than a Part D plan or a Medicare Advantage plan that provides prescription drug benefits, at the time you apply.
  5. Not be eligible for a full federal low-income subsidy under 42 CFR §423.772.

Condition 5 runs the opposite way from what applicants expect. Full Extra Help doesn't lead to Maryland SPDAP; it disqualifies you. The enrollment application says plainly that if you are currently eligible for and receiving a 100 percent full federal low-income subsidy through Extra Help, or are eligible for Medicaid, you do not qualify for SPDAP.

If you're in a Medicare Savings Program, condition 5 is already answered. Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help, the Part D low-income subsidy, because federal rules deem those three groups full-subsidy eligible. That full subsidy is what condition 5 shuts the door on, so if you're already in QMB, SLMB, or QI, work the Medicare Savings Programs and Extra Help track instead. Maryland publishes the standard federal MSP limits for 2026: monthly income up to $1,350 for one person and $1,824 for a couple at the QMB tier, $1,616 and $2,184 at SLMB, and $1,816 and $2,455 at QI, with a resource standard of $9,950 and $14,910 across all three. Those are the federal standards rather than absolute cutoffs: states can effectively raise both the income and the resource limits by disregarding certain income and resources, so someone somewhat over should apply rather than rule themselves out. And QI has to be applied for again every year, because being selected one year does not carry you into the next, and states approve QI applications first come, first served, so applying early in the year beats applying late. Questions go to the Medicare Savings Program at the Maryland Department of Health at 1-800-638-3403.

There's no partial tier to weigh here either. The Inflation Reduction Act eliminated the partial Extra Help subsidy effective January 1, 2024, so everyone who qualifies for Extra Help now receives the full subsidy.

What counts as household income. COMAR 10.09.60.02B is where the operative definition sits, and it does two things the income chart alone won't tell you. First, the figure is the earned and unearned income of you and a spouse sharing your residence projected forward for a 12-month period beginning with the month you submit the application, not what you took in last year. For anyone who has just retired, or just lost a spouse's pension, that is a different and usually smaller number. Second, it draws a line straight through the help families most often give. Support and maintenance furnished in-kind is not unearned income, and the regulation spells out what it means by that: room, rent, garbage collection services, mortgage payments, real property tax payments, and heating fuel, gas, electricity, water, and sewage payments. So an adult child who covers your utilities or your mortgage adds nothing to the figure you report.

Cash from the same child runs the other way, and applicants get this backwards. Support from absent relatives, support from legally responsible relatives, and income received on a regular basis from relatives and friends who are not legally responsible all count as unearned income, so a standing monthly allowance belongs in the projection. Earned income also reaches the value of nonmonetary compensation you receive for services rendered and profit from rent received from a roomer, tenant, or boarder. Getting it wrong in your own favor is not a free bet: an enrollee who ceases to meet the criteria may be disenrolled after reasonable notice.

Here is what condition 3 works out to in dollars for 2026. What COMAR sets is a multiple rather than a table: 300 percent of the federal poverty guideline that applies to your household size. So every ceiling below is the 2026 federal poverty guideline for that household size multiplied by three. The middle column is where each figure in the right-hand column comes from.

Household size 2026 federal poverty guideline 300 percent of it (the SPDAP income ceiling)
1 person $15,960 $47,880.00
2 people $21,640 $64,920.00
3 people $27,320 $81,960.00
4 people $33,000 $99,000.00
5 people $38,680 $116,040.00
6 people $44,360 $133,080.00
7 people $50,040 $150,120.00
8 people $55,720 $167,160.00

The guideline column is the 2026 schedule for the 48 contiguous states and the District of Columbia, which is the one Maryland falls under. Above eight people, the guideline adds $5,680 for each additional person, so the SPDAP ceiling rises by $17,040 a head. Maryland SPDAP's own 2026 enrollment application prints this chart, and the two figures it publishes for one- and two-person households, $47,880.00 and $64,920.00, are exactly those multiples.

Because the ceiling is a multiple of the guidelines, it moves every time they do. Check the current year's application before you rule yourself out, especially within a few thousand dollars of the line.

Nothing in COMAR 10.09.60.02's five conditions is an asset or resource test, so what a Maryland SPDAP applicant holds in savings is not among the tests the regulation names. On Medicare under 65 through disability? Work those same five conditions with a counselor; the program's name isn't the eligibility test.

How SPDAP Works With Medicare Part D

Maryland SPDAP buys down the price of a Medicare drug plan; it never stands in for one, and federal rule fixes which pays first. Under 42 CFR 423.464(b), "A Part D plan is always the primary payer relative to a State Pharmaceutical Assistance Program." Your Part D or Medicare Advantage plan adjudicates every prescription first, and the state program is secondary by federal design. The coordination is a duty on the plan rather than a courtesy it can decline: under 42 CFR 423.464(a) a Part D plan "must permit SPAPs ... to coordinate benefits with such plan," and it must comply with the CMS processes for that coordination, which cover payment of premiums and coverage as well as payment for supplemental prescription drug benefits.

For Maryland SPDAP that secondary role is a monthly credit against your plan premium; it doesn't touch what you owe at the register. So the plan you choose still determines your formulary, your copays, and your pharmacy network.

One more federal mechanic reads in Maryland's favor and then doesn't. Under the definition of "incurred costs" at 42 CFR 423.100, money paid under a State Pharmaceutical Assistance Program counts toward your annual out-of-pocket threshold. But that definition is a two-part test and both halves have to be satisfied: the cost has to be a kind of cost paragraph (1) describes, chiefly a covered Part D drug your plan didn't pay for because of the deductible or another cost-sharing rule, and it has to be paid in one of the ways paragraph (2) describes, which is the limb that names a State Pharmaceutical Assistance Program. Maryland SPDAP misses the first half by design. It buys down a premium, and the Maryland Insurance Administration describes it as a premium subsidy only program that does not help with out-of-pocket drug costs, while a premium is "a monthly amount you pay for coverage, whether you get covered drugs or not" rather than out-of-pocket spending on a drug. So don't count SPDAP's $100 a month as progress toward the threshold. Plenty of other help does count, and not only money out of your own pocket: from 2025 on, costs reimbursed through insurance, a group health plan, or another third-party payment arrangement count too.

For 2026 that threshold is $2,100, and once your out-of-pocket spending on covered Part D drugs reaches it you won't have to pay out of pocket for covered Part D drugs for the rest of the calendar year. Your premium is not over, though. A premium is owed whether you fill a prescription or not, and any Part D late enrollment penalty stays added to it, so the cap does not end the bill SPDAP exists to help with. For how that threshold works, see our guide to the Medicare Part D out-of-pocket cap.

What SPDAP Membership Changes About Switching Plans

Membership in a qualified State Pharmaceutical Assistance Program carries a Medicare Part D special enrollment period (SEP) under 42 CFR 423.38(c)(17), which lets a member change plans outside the usual fall window. Under that rule the individual "is eligible to make one enrollment election per year." Maryland SPDAP is an MDH program that subsidizes a Part D or Medicare Advantage premium and sets eligibility on income, so a Maryland member should expect that election to be available. Confirm it with your plan or a counselor at Maryland's State Health Insurance Assistance Program (SHIP) before you count on it.

For a member of a qualified SPAP that one election covers the whole year, and it doesn't renew. If you spot a better formulary fit two months after switching, this SEP won't carry you into a second change until the next year. That limits this SEP, not your ability to change plans at all: the fall Open Enrollment Period and any other SEP you separately qualify for are unaffected.

The SEP runs while you are enrolled in a qualified SPAP, and if you lose eligibility for SPAP benefits it stays open for an additional two calendar months after either the month of the loss or the month you are notified, whichever is later. Where Maryland SPDAP qualifies, the same plan change that uses up your one election can also end your SPDAP membership, under the rule described next.

Two Rules That Can Cost You Your Spot

The enrollment cap and the waiting list. SPDAP is not an entitlement that expands to meet demand. SPDAP's administrator may not enroll additional individuals once the program's total enrollment reaches the level MDH authorizes, and the program maintains a waiting list of people who meet the eligibility requirements but are not served because of funding limitations. Neither document that governs the cap states its size: COMAR 10.09.60.02 names the enrollment level the Department authorizes without giving a number, and the enrollment application carries none either. So there is no published slot count to measure yourself against. As of December 2023, total SPDAP enrollment was 24,354 members; call the SPDAP call center at 1-800-551-5995 to ask where enrollment and the waiting list stand now. The cap is not a permanent door, either. If the number enrolled decreases after the program has reached the maximum capacity the Department sets, the administrator may recommence enrolling eligible individuals until enrollment reaches that maximum again, though the Department may also direct the administrator to limit enrollment based on the money remaining in the Program Fund. Apply and take a waiting-list place if that's what's available; don't hold off for a year when the queue looks shorter.

Not sure whether SPDAP or Extra Help is the right first application? Chat with Brevy's care navigator at brevy.com.

How to Apply for Maryland SPDAP

The application is a paper form, returned to the program's administrator by mail or fax.

  1. Get the current enrollment application from the Maryland SPDAP program site, or call the SPDAP call center at 1-800-551-5995 and ask for one.
  2. Attach proof of six months of Maryland residency for every applicant. The application names examples such as a Maryland driver's license, a state identification card, a voter registration card, or a utility bill dating back six months.
  3. Attach your most recent federal income tax return. That is the income documentation the application asks for. The return is documentation, not the test: the test is the forward-looking 12-month projection described above, so a return showing a year you are no longer living is not the last word.
  4. Send it back. Mail the completed application to Maryland SPDAP c/o International Software Systems, Inc., PO Box 749, Greenbelt, MD 20768-0749, or fax it to 800-847-8217.
  5. Keep paying your plan premium in full while you wait, and call the SPDAP call center at 1-800-551-5995 to ask where your application stands. If the premium is the bill you can't carry, look again at the Medicare Savings Programs boundary above before you count on SPDAP: an MSP pays your Medicare Part B premium and, at the QMB tier, your Medicare deductibles, coinsurance, and copayments too.

One sequencing note: SPDAP's second condition requires that you already be enrolled in a Part D plan or a Medicare Advantage plan with Part D coverage, so if you have neither, sort that out first. A counselor at Maryland SHIP (official page), the Maryland Department of Aging's State Health Insurance Assistance Program, gives free, unbiased one-on-one assistance, and in Maryland SHIP also assists with SPDAP. Our guide to Medicare plans and coverage in Maryland covers the wider picture.

Frequently Asked Questions

Can I get Maryland SPDAP if I already have Extra Help?

Maryland SPDAP's fifth eligibility condition rules you out if you are eligible for the full federal low-income subsidy under 42 CFR §423.772, and the enrollment application tells anyone eligible for Medicaid not to apply either. Find out which subsidy you actually hold before you mail a Maryland SPDAP application. The enrollment application carries the SPDAP call center number, 1-800-551-5995. Counselors at Maryland's State Health Insurance Assistance Program screen for Medicare Savings Program and Extra Help eligibility free of charge.

If Maryland SPDAP puts me on the waiting list, am I enrolled?

No. Maryland SPDAP's waiting list holds people who meet every eligibility requirement but are not served because of funding limitations, and it exists because the administrator may not enroll anyone further once total enrollment reaches the level MDH authorizes. COMAR 10.09.60.02 names that authorized level without stating what it is, so there is no published figure to check yourself against. Meeting the criteria and holding a place on that list are two different things. The list is not a dead end: if enrollment later decreases, the administrator may recommence enrolling until the program is full again, subject to the Department's power to limit enrollment based on the money left in the Program Fund. Carrying the premium on your own while the application sits is the hard part of this. Keep paying it, because SPDAP's second condition requires that you already be enrolled in a Part D or Medicare Advantage drug plan, so that coverage has to stay in force. The SPDAP call center at 1-800-551-5995 can tell you where your application stands, and a Medicare Savings Program is worth checking against your income while you wait. Maryland's 2026 QMB monthly income limit is $1,350 for one person and $1,824 for a couple, with a resource standard of $9,950 and $14,910. Those are federal standards rather than absolute cutoffs, so apply if you are somewhat over.

Is SPDAP the same thing as a SPAP?

SPAP is the federal category and SPDAP is Maryland's program within it. 42 CFR 423.464(e)(1) defines a State Pharmaceutical Assistance Program as a state program meeting a specific federal test, and it excludes state Medicaid programs, section 1115 demonstration programs, and any program funded from federal grants or other federal sources. The distinction decides what travels: a federal rule written for SPAPs, such as the special enrollment period, is what a Maryland SPDAP member looks to, while SPDAP's own dollar amount and eligibility chart are Maryland's alone.

Is Maryland SPDAP scheduled to end?

Not in the near term. The Maryland Insurance Administration reports that Senate Bill 219 extends the program to December 31, 2030. MDH resets the maximum monthly premium subsidy for each calendar year, so check the current year's application for the dollar amount.

Learn More

MedicareState Pharmaceutical Assistance Programs and Your Medicare Drug CostsThirteen states run a State Pharmaceutical Assistance Program (SPAP) that helps pay Medicare Part D drug costs. See which states, and how a SPAP works. MedicareMedicare Plans and Coverage in MarylandMedicare in Maryland for 2026: Part A and B costs, Medicare Advantage, Part D, the 30-day Medigap birthday rule, savings programs, and free SHIP help. MedicareMedicare Extra Help: The Part D Low-Income SubsidyMedicare Extra Help can cut Part D drug costs to a few dollars a prescription. See 2026 income and resource limits, what it pays, and how to apply. MedicareHow Medicare Part D WorksMedicare Part D in 2026: a $2,100 out-of-pocket cap, no donut hole, three benefit phases, the $615 deductible, premiums, the late penalty, and Extra Help. MedicareMedicare Savings Programs: Help Paying Premiums and CostsMedicare Savings Programs help low-income enrollees pay Part B premiums and, with QMB, all cost-sharing. See the four MSPs, 2026 limits, and how to apply.

Find personalized help sorting out SPDAP, Extra Help, and your Medicare drug plan in Maryland 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.

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