Special Pharmaceutical Benefits Program
Provides pharmaceutical assistance and
specific lab services to low to moderate income individuals living with a
diagnosis of HIV/AIDS who are not eligible for pharmacy services under
the Medical Assistance (MA) Program.
Applicants must be a
resident of Pennsylvania, have a gross annual income of less than or
equal to 500 percent of the Federal Poverty Level (FPL), and have a diagnosis
of HIV/AIDS to qualify for the program. SPBP HIV/AIDS is the payer of
last resort and third party resources must be used before payment is
made by the program.
SPBP Covered Drug List (Effective 01-01-18).pdf
SPBP Covered Laboratory Services - Effective 02-05-2018.pdf
SPBP Laboratory Network (Updated 08-16-17).pdf
SPBP Pharmacy Network (Updated 08-01-17).pdf
SPBP Medicare Part C and D Plans with Premium Payment Agreements 2018 (Updated 01-24-18).pdf
SPBP Medicare Part C and D Premium Assistance Program Overview and FAQ 2018.pdf
Income Quick Reference Guide (Effective 01-13-18).pdf
HIPAA Notice of Privacy Practices
Pennsylvania Integrated HIV Prevention and Care Plan_2017-2021.pdf
How to Apply:
For assistance or additional information please call the SPBP Customer Service Line at 1-800-922-9384.
Special Pharmaceutical Benefits Application.pdf
El Programa Especial de Beneficios Farmacéuticos (SPBP).pdf
Special Pharmaceutical Benefits Program - Mental Health
Pennsylvania Department of Human Service provides service to
individuals with schizophrenia who do not respond to first-line drug
therapies and who are not eligible for pharmaceutical coverage under the
MA Program. Information is available at: Special Pharmaceutical Benefits Program - Mental Health .