Prescription drugs
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How to Apply

Download the Enrollment Application and instruction sheet.

The Enrollment Application is in PDF format, so you will need Adobe Acrobat Reader to view
this file. If you do not have Acrobat Reader, you can download it for free from Adobe by clicking the link below.


Once your application to SPDAP is approved, we will submit your information to Medicare in order to obtain information on which MedicareRx prescription drug plan you are enrolled. Once your plan enrollment information is received from Medicare, SPDAP will begin coordinating program subsidy payments to your MedicareRx plan.

Do not have your Medicare drug premiums automatically deducted from your Social Security check. If you are currently having your premium deducted from your Social Security check, contact your Prescription Drug Plan and request direct billing.

Request an Enrollment Application by mail.

Complete this form and we'll send you an application by mail:
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