Eligibility Criteria:
Applicants must:
- be an Oklahoma resident.
- Have documented HIV infection and/or a documented AIDS diagnosis.
- Have a physician’s prescription(s) for the drugs listed on the HDAP formulary.
- Have a monthly family household gross income of not more than 200% of the Federal Poverty Guidelines (e.g. 1 person - $1,915 a month) for those with no health insurance and 400% of the Federal Poverty Guidelines (e.g. 1 person - $3830 a month) for those with health insurance and applying for health insurance assistance for premiums and program drug formulary prescription co-payments through HDAP.
- Applicants with health insurance & Medicare D prescription coverage may qualify for health insurance premium and prescription co-pay assistance.
- Applicants eligible for any third party coverage including Medicaid, COBRA, Insure Oklahoma, employer, Federal Marketplace must make application and access prescription coverage available.
Application Instructions:
- The HDAP application and assistance with completing the application is available through one of the designated HDAP access case managers (see list on last page of brochure).
- The HDAP case manager submits the completed application with documentation to OSDH for review and determination of eligibility.
- Certifications will be up to 6 months of the program year (April 1- March 31) or calendar year for Med D and Federal Marketplace.
- Applicants who qualify for third party coverage (e.g. Medicaid) will be given a provisional certification .
Location
Address:
1000 N.E. Tenth
Room 614
Oklahoma City, OK
73117-1299