To qualify for ADAP services, a person must meet the following criteria:
- Be diagnosed as having AIDS or HIV;
- Complete the Department’s ADAP Online Application;
- Qualify financially, which will be accessed as follows using the current Federal Poverty Level published annually by the U.S. Department of Health and Human Services for the size of the household
- New Applicants or previously enrolled clients whose status is classified by ADAP as “closed” as of July 1, 2011: 300% FPL
- Active Applicants enrolled in ADAP prior to July 1, 2011: 500% FPL
- New applicants who make over 300% of the FPL as of July 1, 2011: eligible for the Illinois Preexisting Condition Plan (IPXP), a state-operated insurance program. Upon enrollment, IPXP clients can apply for ADAP cost-sharing assistance.
- Documentation of support for applicants with no income or income of $500 or less.
- Not eligible for medical assistance through the Illinois Department of Healthcare & Family Services, Medical Assistance Program on the date drugs are obtained.
- If eligible for health insurance coverage, the company must be willing to participate with the contracted dispensing pharmacy for dispensing and billing purposes and only drugs on the ADAP Formulary will be covered. In addition, applicant’s insurance company cannot mandate greater than 30 day medication fills. If either of these two requirements are not compatible with the applicant’s insurance policy, then the applicant is NOT eligible for ADAP services (provide a clear copy of the front and back of the insurance card);
- If applicant is Medicare Part-D (prescription drug plan) eligible, then provide a clear copy of the front and back of the Medicare Part-D insurance card;
- If applicant is Federal Extra Help and Illinois Cares Rx eligible, applicant is required to apply to both programs and approval/denial letters are required to be forwarded to ADAP; and
- Be a resident of and domiciled in Illinois.
Clients will need to provide proof of income, most recent CD4 and Viral Load test results, and Illinois residency. They will also be cross-checked with the Medicaid database to ensure that they aren't eligible for Medicaid coverage.
State covers some form of HCV drug therapies as part of their approved drug formularies: Yes
To learn more about what HCV drug therapies are on the drug formulary, please visit tiicann.org/co-infection-watch.html (go to page #7).