Special Pharmaceutical Benefits Program (SPBP)

Special Pharmaceutical Benefits Program (SPBP) covers prescriptions and some lab services for people with HIV/AIDS or with a diagnosis of Schizophrenia. It is not a health insurance program.

SPBP applications and re-enrollment forms may now be submitted by email to spbp@magellanhealth.com. Click here to download a copy of the application.

For more information on the program, click here.

Effective January 24, 2013, the income limit for new applicants for SBPB has been raised from 337% of the Federal Poverty Income Guidelines (FPIG) to 500%. SPBP has no resource limit.

This means individuals applying for the first time and persons recertifying to stay on the program will have the same income limits. In 2013, an individual can have income up to $57,450.00 (one-person household) when applying for the benefit. See the chart below for SPBP income guidelines:

EFFECTIVE:  1/24/13

ALLOWANCES
ALL APPLICANTS

$20,100.00 Each

ALL
APPLICANTS

$57,450.00

SINGLE $57,450.00
1 $77,550.00
2 $97,650.00
3 $117,750.00
4 $137,850.00

To implement the change in program eligibility income, SPBP has reviewed and re-processed any applications received on or after the effective date.  The program has also sent letters with enrollment forms to all SPBP cardholders (back to April of 2012) who had either been denied because of excess income, or failed to re-enroll timely and lost the expanded benefit inviting them to re-apply based on the new income limits. Further, the Program will apply the new income limits as necessary to resolve any appeals from income-related denials.

Contact your case manager or the AIDS Law Project at (215) 587-9377 for more information on applying for SPBP.

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