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The Wyoming Prescription Drug Assistance Program (PDAP)

 

PDAP is 100% state funded and is administered through the Wyoming Department of Health/Office of Healthcare Financing/Office of Pharmacy Services.

 

Eligibility:  Client eligibility for the program is determined by the client’s local Department of Family Services (DFS) office.

            Income guidelines are at 100% of Federal Poverty Level (FPL)

                        Individual Monthly Income of $850.83—Yearly Income of $10,200

                        2 Person Household:  Monthly--$1,140.83 and Yearly--$13,690

                        3 Person Household:  Monthly--$1,430.83 and Yearly--$17,170

 

Effective June 1, 2003:  AIDS drugs were no longer covered because the Aids Drug Assistance  Program (ADAP) covered them.

 

Effective July 1, 2003:  A cap on new enrollments in the program was instituted. Clients currently eligible were continued in the program provided they completed their yearly review with DFS and still met eligibility criteria.

 

Effective July 1, 2004:  Begin implementation of the new asset test upon annual review.

            Must be at 100% of FPL or less

            A vehicle worth $15,000 or less, the home the client is living in, and $2,500

                        in resources will be excluded from the means test.

 

Effective July 1, 2006:  The program cap on new enrollments was lifted due to the shift of those clients eligible for Medicare Part D Prescription Services beginning January 1, 2006

 

Benefit:  Three (3) prescriptions per month, with a $10 co-pay for generics and a $25 co-pay for brand-name drugs.

 

Formulary:  Same as for Wyoming Medicaid—a comprehensive listing can be found at:

http://www.epocrates.com 

 

Preferred Drug List can be found at:  http://uwacadweb.uwyo.edu/PDL

            Coverage exclusions:

                        (1) Weight loss (anorexiants)

                        (2) Fertility drugs

                        (3) Hair growth agents

                        (4) Cosmetic agents

                        (5) Weight gain agents including anabolic and androgenic steroids

 

 

 PRESCRIPTION DRUG ASSISTANCE PROGRAM (PDAP) CLIENTS--WHAT YOU NEED TO KNOW ABOUT MEDICARE PRESCRIPTION DRUG BENEFITS

 

Beginning January 1, 2006, new Medicare prescription drug plans will be available to people with Medicare. Insurance companies will work with Medicare to offer these drug plans, which are different from the Medicare-approved drug discount cards.  Medicare prescription drug plans provide insurance coverage for prescription drugs. All drug plans will provide at least a standard level of coverage, which Medicare has set, but could offer more coverage and additional drugs for a higher monthly premium. When a person joins a drug plan, it is important to choose one that meets the person’s prescription drug needs.

For those clients who are also eligible for Medicare, prescription drug benefits will continue through PDAP until May 31, 2006.  Pharmacies can continue to bill the PDAP program using the EqualityCare ID number until that time.  The Department highly recommends that PDAP clients enroll in a Medicare Prescription Drug Plan, as well as the Extra Help, as this is a much better benefit than that offered through PDAP.  To enroll in a Medicare plan, call 1-800-Medicare (1-800-438-5785) or visit their website at www.medicare.gov.  

For PDAP clients who are NOT eligible for Medicare, benefits will continue as usual.