OAR 461-155-0688: Prescription Drug Co-pay Coverage

In the OSIPM program for a client who is receiving SSI: (1) The Department will provide a payment for all Medicare Part D or Veteran's Administration Health Care prescription co-pays if a client's co-pays exceed $10 per month. (2) Payment for Medicare Part D co-pays is limited to the current Low-Income Subsidy (LIS) program amounts for a fully dual eligible individual under 100 percent of the Federal Poverty Limit. (3) If the payment exceeds $30 per month, it must be approved by the Aging and People with Disabilities Medicaid Financial Eligibility policy unit.