Arizona

The AIDS Drug Assistance Program (ADAP) helps ensure that people living with HIV and AIDS who are uninsured and under-insured have access to medication.

Eligibility Criteria

In the State of Arizona, to be eligible for ADAP enrollment, an individual must meet the following criteria:

  • Have a positive HIV/AIDS diagnosis.
  • Be a resident of Arizona.
  • Be under 400% of the federal poverty level (FPL).
  • Proof of HIV diagnosis (required with initial application).
  • Payer-of-last-resort documentation: Proof that all other forms of insurance and coverage are used before ADAP funds.
    • Denial letter from AHCCCS (Arizona's Medicaid program) if income is below 150% of the FPL.
Application Instructions

New ADAP users must complete a Full Application and New Applicant Addendum. The application and support documents must be submitted to your Case Manager, sent to eligibility@siren.az.gov or our secure fax at 602-364-3263.

For general questions on how to complete the application, please feel free to review the Joint Application Processing Guide found here.

For additional enrollment assistance, we strongly encourage you to work with a case manager.

Hepatitis C (HCV) Drug Therapy
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 https://www.hiv-hcv-watch.com/watches.

Long-Acting Injectables (LAIs) Therapy
State covers LAIs as part of their approved drug formularies: No

To learn more about what LAIs drug therapies are on the drug formulary, please click here.

Contact Information

Address

Arizona Department of Health Services
150 N. 18th Ave
Phoenix, AZ 85007
United States

Phone Number
800-334-1540 or 602-364-3610
Fax Number
602-364-3263
Email Address
eligibility@siren.az.gov

33.4500248, -112.0991488