Maine DEL Program — Low Cost Drugs for the Elderly and Disabled

What DEL Is and Who It's For

DEL — Low Cost Drugs for the Elderly or Disabled — is Maine's State Pharmaceutical Assistance Program (SPAP), created under 22 M.R.S. § 254-D. It's a wrap-around drug benefit that sits behind Medicare Part D and Extra Help, picking up costs those programs don't fully cover.

To qualify, you must meet all four criteria:

• Age or disability: 62 or older, OR aged 19–61 and disabled under SSI disability criteria
• Maine residency: Legal resident of the state
• Income: Countable gross household income at or below 185% FPL ($2,461/month single in 2026)
• Asset test: None — eliminated effective January 1, 2024

There's also a high-drug-expense adjustment: if an applicant spends 40% or more of gross monthly income on unreimbursed prescription costs, the income limit jumps 25% — effectively raising eligibility to about 231% FPL.

What DEL Covers

DEL maintains a basic drug list covering medications for:

• High blood pressure
• Cholesterol
• Heart disease
• Diabetes
• Arthritis
• Respiratory illness (COPD, asthma)
• Parkinson's disease

For drugs on this list, DEL caps the enrollee's out-of-pocket cost at $2.00 plus 20% of the state-approved drug cost. The savings layer on top of whatever Part D and Extra Help already paid.

How DEL Coordinates with Part D and Extra Help

DEL operates as a secondary payer. The claim sequence works like this:

1. The pharmacy submits the prescription to the primary Medicare Part D plan
2. Part D and Extra Help absorb their portion of the cost
3. The remaining balance goes to DEL
4. DEL pays down to the $2.00 + 20% cap

Because DEL is a CMS-recognized qualified SPAP under 42 CFR 423.464, every dollar DEL pays on behalf of the enrollee counts toward Part D True Out-of-Pocket (TrOOP) spending. This accelerates the beneficiary through the Part D benefit phases, potentially reaching the out-of-pocket cap faster.

DEL enrollment also grants a Special Enrollment Period (SEP), allowing the beneficiary to switch Part D plans once per calendar quarter outside the annual Open Enrollment Period — useful if a current plan doesn't cover a needed medication.

You Might Already Be Enrolled

Since July 1, 2024, Maine automatically enrolls MSP recipients who meet DEL income standards. If your parent was approved for QMB or QI and their income is at or below 185% FPL, they're deemed eligible for DEL — no separate application required.

This automatic enrollment catches most eligible people, since QMB's income ceiling in Maine is also 185% FPL. The only gap: QI enrollees earning between 185% and 250% FPL don't automatically qualify for DEL, though they still get Extra Help through their QI status.

How to Apply If You're Not Automatically Enrolled

For people who aren't already on an MSP — such as a 62-year-old who isn't yet on Medicare but has a disability determination — DEL has its own application pathway through the MaineCare system. The same integrated application used for MSP covers DEL. Submit through:

• My Maine Connection (mymaineconnection.maine.gov)
• OFI Telephonic Center: 1-855-797-4357
• Mail: Office for Family Independence, 114 Corn Shop Lane, Farmington, ME 04938

People receiving full MaineCare pharmaceutical benefits are excluded from DEL — the programs don't stack.

What DEL Doesn't Cover

DEL covers medications on the basic drug list only. Specialty drugs, biologics, and medications for conditions not on the list are handled by Part D and Extra Help alone. The formulary is updated periodically by Maine DHHS.

For a detailed breakdown of how DEL, Extra Help, and Part D work together — including what to do when a pharmacy doesn't process the DEL benefit correctly — the Maine Medicare Savings Programs guide maps out the full payer coordination sequence.

See more Maine guides →