Or. Admin. Code § 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.

Notes

Or. Admin. Code § 461-155-0688

SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10; SSP 33-2010(Temp), f. & cert. ef. 10-1-10 thru 3-30-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11: SSP 14-2017, f. 6-5-17, cert. ef. 7/1/2017; SSP 4-2025, minor correction filed 04/08/2025, effective 4/8/2025

Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 411.706, 413.085 & 414.685

Statutes/Other Implemented: ORS 409.010, 411.060, 411.083, 411.404, 411.704, 411.706, 413.085 & 414.685