Residency: You must be a New Jersey resident 30 days prior to the date of your application.
Medical Certification: You must present a letter from a physician that certifies the medical necessity of receiving the covered medication(s).
Consent: You must sign a consent form which attests to the accuracy of the information and allows for verification.
Other Insurance: If you have other forms of reimbursement through private insurance you may not be eligible for our program unless you have received the maximum benefits allowable under the plan.
1. Call 1 (877) 613-4533 to get an application;
2. Ask your case manager.
Mail the completed application to:ADDP
PO Box 722
Trenton, NJ 08625-0722
or fax to: 609-588-7037