Application For Gap Assistance Pharmacy Program For Seniors (Gaps)

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South Carolina Department of Health and Human Services
Application for
Gap Assistance Pharmacy Program for Seniors (GAPS)
Medicare provides prescription drug coverage for people eligible for Medicare. GAPS works with
Medicare’s prescription drug coverage this way:
Most people, who join a Medicare Prescription Drug Plan, after paying a monthly premium, will be responsible
for 100% of their drug costs between $2,830 and $6,440. This gap in Medicare drug coverage that many
people will face is referred to as the “doughnut hole.” GAPS will provide state pharmacy assistance to “fill the
gap” for seniors’ Medicare prescription drug coverage when their drug costs reach the “doughnut hole”. The
GAPS program will pay 40% of your drug costs while you are experiencing the coverage gap.
Before you apply for GAPS, you will need to:
Check to see if you qualify for Extra Help through the Federal government with your prescription drug costs.
The Extra Help program is for those with limited income and resources. If you qualify, Extra Help will benefit
you more than GAPS. If you have not already checked to see if you qualify for Extra Help, please do so. Online
applications are available at
or call (toll-free) 1-800-772-1213. (Note: You do not need
GAPS if you qualify for Extra Help.)
If you qualify for GAPS, you will need to:
Join a Medicare Prescription Drug Plan (PDP). Medicare prescription drug coverage does not begin until you
have joined a drug plan. To benefit from GAPS, you must select a PDP that is participating in GAPS. Not all
PDPs participate in GAPS. Listed below are the participating providers and the Prescription Drug Plans that
are participating in GAPS. Also listed for your convenience are their toll-free telephone numbers.
Medicare Part D Drug Plans
Plan
Phone Number
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Note: GAPS is not a Medicaid program; however, it is administered by the South Carolina Department of
Health and Human Services. Please contact your local Medicaid office if you have never applied for Medicaid
benefits and think you may qualify. If you do not know where to go, visit our agency’s Web site at
or call (toll-free) 1-888-549-0820. Medicaid coverage will benefit you more than GAPS.
DHHS Form 942 (January 2010)
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