§ 42-66.2-5. Persons eligible.
(a) Persons eligible for assistance under the provisions of this chapter include any resident
of the state who is at least sixty-five (65) years of age or at least fifty-five (55)
years of age and receiving social security disability benefits. State and consumer
copayment shares for these persons shall be determined as follows:
(1) For unmarried persons or married persons living separate and apart whose income for
the calendar year immediately preceding the year in which assistance is sought is:
(i) Less than nineteen thousand three hundred forty-one dollars ($19,341) the state shall
provide reimbursement such that the consumer shall pay no more than forty percent
(40%) of the cost of the prescriptions;
(ii) More than nineteen thousand three hundred forty-one dollars ($19,341) and less than,
twenty-four thousand two hundred and eighty dollars ($24,280) the state shall provide
reimbursement such that the consumer shall pay no more than seventy percent (70%)
of the cost of the prescriptions; and
(iii) More than twenty-four thousand two hundred and eighty dollars ($24,280) and less than
forty-two thousand four hundred and ninety-three dollars ($42,493), the state shall
provide reimbursement such that the consumer shall pay no more than eighty-five percent
(85%) of the cost of prescriptions.
(2) For married persons whose income for the calendar year immediately preceding the year
in which assistance is sought hereunder when combined with any income of the person's
spouse in the same year is:
(i) Twenty-four thousand one hundred and seventy-nine dollars ($24,179) or less, the state
shall provide reimbursement such that the consumer shall pay no more than forty percent
(40%) of the cost of the prescriptions;
(ii) More than twenty-four thousand one hundred and seventy-nine dollars ($24,179) and
less than thirty thousand three hundred and fifty-two dollars ($30,352), the state
shall provide reimbursement such that the consumer shall pay no more than seventy
percent (70%) of the cost of prescriptions; and
(iii) More than thirty thousand three hundred and fifty-two dollars ($30,352) and less than
forty-eight thousand five hundred and sixty-three dollars ($48,563), the state shall
provide reimbursement such that the consumer shall pay no more than eighty-five percent
(85%) of the cost of prescriptions.
(3) Eligibility may also be determined by using income data for the ninety-day (90) prior
to application for benefits and projecting that income on an annual basis. The income
levels shall not include those sums of money expended for medical and pharmaceutical
that exceed three percent (3%) of the applicant's annual income or three percent (3%)
of the applicant's preceding ninety-day (90) income computed on an annual basis.
(4) For persons on social security disability benefits who are: (i) unmarried or married
and living separate and apart with income for the calendar year immediately preceding
the year in which assistance is sought that is less than forty-two thousand four hundred
and ninety-three dollars ($42,493); or (ii) married with income that is less than
forty-eight thousand five hundred and sixty-three dollars ($48,563) the state shall
provide reimbursement such that the consumer shall pay no more than eighty-five percent
(85%) of the cost.
(b) On July 1 of each year, the maximum amount of allowable income for both unmarried
and married residents set forth in subsection (a) shall be increased by a percentage
equal to the percentage of the cost of living adjustment provided for social security
recipients.
(c) The fact that some of a person's prescription drug expenses are paid or reimbursable
either in whole or in part, under the provisions of the federal Medicare program shall
not disqualify that person, if the person is otherwise eligible, to receive assistance
under this chapter, provided that if the federal share equals or exceeds sixty percent
(60%) of the cost the state shall make no payment.
(d) For all additional drugs, the consumer shall pay one hundred percent (100%) of the
cost of prescriptions as set forth in § 42-66.2-4.
(e) To promote coordination of benefits between the pharmaceutical assistance program
created under this chapter and the Medicare Part D prescription drug program created
in the federal Medicare Prescription Drug, Improvement and Modernization Act of 2003,
RIPAE enrollees must apply for and enroll in the Medicare Part D prescription drug
program.