HIV, STD and Hepatitis Branch

phs_logo

AIDS Drug Assistance Program (ADAP)

For more information, phone 619-293-4722 or send us an email.

The AIDS Drug Assistance Program (ADAP) in San Diego County is administered by the HIV, STD and Hepatitis Branch (HSHB).

ADAP helps ensure that HIV positive uninsured and under-insured individuals have access to pharmaceutical (drug) therapies.

The goal of ADAP is to make available in a timely manner drug treatments that can reliably be expected to increase the duration and quality of life of people living with HIV. Currently, over 181 drugs are available through ADAP. There are approximately 3,500 participating pharmacies statewide and 250 participating San Diego pharmacies where clients can access these drugs. Without the drugs available through ADAP, thousands of HIV positive Californians would face rapidly deteriorating health.

Who we serve:

Individuals are eligible for ADAP if they:

  • are a resident of California;
  • are HIV infected;
  • are 18 years of age or older;
  • have an adjusted gross income below $50,000 per year;
  • have a valid prescription from a licensed California physician; and
  • lack private insurance that covers the medications or do not qualify for Medi-Cal.

Persons with an annual adjusted gross income below 400 percent of the federal poverty level receive ADAP drugs at no cost. A co-payment is required of anyone whose annual adjusted gross income is between 400 percent of federal poverty level (this changes yearly) and $50,000.

ADAP for persons with other prescription drug coverage:

Federal and state law requires that ADAP funds be used as the payer of last resort. The goal of ADAP is to help individuals access and maintain HIV prescription drug coverage, while ensuring that ADAP is used only after all other payer options are exhausted.

- Medicare Part D: Medicare eligible ADAP clients are required to utilize the prescription drug benefits available under Medicare Part D. ADAP will be able to assist clients in meeting some out-of-pocket costs associated with the various levels of coverage available under Medicare Part D.

- Private Insurance: Persons eligible for private insurance coverage are required to utilize that plan's prescription drug coverage benefit. ADAP is able to assist clients in meeting some out-of-pocket costs associated with private insurance prescription drug coverage.

- Persons who are eligible to receive insurance but are in need of premium payment assistance can refer to the Comprehensive AIDS Resources Emergency/Health Insurance Premium Payment (CARE/HIPP) Program or the Medi-Cal HIPP Program.

What you should know:

- AIDS drugs (antiretrovirals) delay progression of the disease and help prevent life threatening infections that HIV positive individuals are susceptible to due to their suppressed immune systems. As a result, AIDS drugs enhance the quality of life for many HIV positive persons and enable them to remain healthy and to continue working, thus reducing the cost of publicly funded health care services.

- In 2007, California ADAP served 31,800 clients and filled over 910,000 prescriptions. In 2007, San Diego ADAP served 3,525 clients and filled over 103,000 prescriptions.

- To enroll in ADAP, HIV positive individuals may go to any of the 239 enrollment sites located throughout California. For a list of enrollment sites in San Diego County, call (619) 293-4722.

Helpful resources:

- To find out more about the ADAP drug formulary (the list of ADAP covered drugs), eligibility information, etc., please call Ramsell Public Health Rx, the ADAP pharmacy benefits management service provider, at toll-free (888) 311-7632 or go to http://www.publichealthrx.com.

- For more information on Medicare Part D, go to the Centers for Medicare and Medicaid Services (CMS) website http://www.cms.medicare.org, or call (800) MEDICARE.

- For information about the Medi-Cal HIPP Program, call (866) 298-8443.

- For more information about the OA-Health Insurance Premium Payment Program (OA/HIPP) call the State Office of AIDS at (800)367-1467 or visit www.cdph.ca.gov/programs/aids/Pages/tOAHIPPindiv.aspx.

 

For more information, phone 619-293-4722 or send us an email.