Eligibility Criteria:
To be eligible for the OHDAP formulary program, the applicant must:
- Submit a complete application and demonstrate a willingness to sign all forms and to provide necessary documentation.
- Be a resident of Ohio.
- Have a monthly gross income that meets our Financial Eligibility Guidelines (500% of the Federal Poverty Level, adjusted for family size). Applicants with an income at or below the federal poverty level are required to have an ODH-Approved Part B Medical Case Manager who can assist them in accessing all eligible services.
- Provide proof of monthly income (for the applicant, as well as the applicant's legal spouse and/or dependents). This includes copies of pay stubs for the most recent 30 consecutive days of employment, Social Security Income award letters, copies of unemployment compensation stubs, etc.
- For the self-employed: provide a copy of an IRS Income Tax Transcript for the most recent tax year.
Application Instructions:
Complete the Ryan White Part B Application and include all required documents. Contact a case manager or call 800-777-4775 for instructions on submitting the application.
Hepatitis C (HCV) Drug Therapy:
State covers some form of HCV drug therapies as part of their approved drug formularies: No
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).
Location
Address:
246 N. High Street
Columbus, OH
43215