New Mexico residents seeking assistance through ADAP must complete a Department of Health ACCESS application.
In order to be eligible for Bridge and Insurance Assistance Programs, applicants must:
- Provide documentation of New Mexico residency (P.O. Box is NOT an acceptable address)
- Have a verified HIV positive diagnosis
- Have a current HIV medication prescription
- For participation in the Insurance Assistance Program and Medication Bridge Program have a documented gross monthly income that is 400% of the Federal Poverty Level (FPL) or below. Documentation must be submitted to support income declaration
- Not be eligible for medication coverage through a third-party payer (Medication Bridge Program)
- Be currently enrolled in HIV case management with a NM Department of Health (NM DOH) contracted HIV Service Provider Provide lab results (CD4 and viral load dated within six months of enrollment)
- Homeless clients require a notarized statement of homeless status from case manager
- Zero income clients require a client signed statement of zero income as well as a letter of support from the individual providing support to the client
- Applicants do not have to document U.S. citizenship or immigration status in order to be eligible for services. However, eligible clients must live in the state of New Mexico and need to provide proof of New Mexico residency
NM DOH ACCESS Applications are available from the NM DOH contracted service providers. Applications must be completed in their entirety before submission to NM DOH. The NM DOH only accepts and processes applications that are filled out completely and accurately. Applications must include documentation of residency, income verification, insurance documentation and current lab results.
Applications received without the above mentioned documentation will be considered incomplete. Incomplete applications will be logged as incomplete and correspondence will be submitted to the service provider or case manager stating the necessary documents needed. The three day (working day) processing time from receipt of application will not apply to incomplete applications. Acceptance into the Program is on a first come first served basis. The applicant is responsible for providing all proof of residency and financial eligibility documentation. The physician is responsible for providing all proof of required medical information.
Time Frames: During the client’s initial intake appointment, case managers are expected to assist with assist with the ACCESS and starting insurance application and enrollment (Medicaid, HIX, NMMIP, etc.). If needed, the case manager can request 30 days of emergency Bridge medications to cover the client until enrollment in insurance is approved/completed. Once insurance is approved, the case manager submits an IAP application. IAP applications will be reviewed upon receipt and approvals will be finalized once full NMDOH program enrollment has been approved. Approved IAP applications will usually be activated immediately. Once a decision is made, patients and case managers will receive written notification within 10-15 working days of final determination of IAP application status. Any changes to the IAP application once submitted will result in additional processing time.