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.
How to Apply
Online Form

Printable Form
For assistance or additional information, please contact the SPBP Customer Service at 1-800-922-9384 or by email at SPBP@pa.gov.
MRx Initial Enrollment