
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
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 tiicann.org/co-infection-watch.html (go to page #7).
Long-Acting Agents Therapy - Cabenuva:
State covers Cabenuva as part of their approved drug formularies: Yes
Location
Address:
1000 N.E. Tenth St
Mail Drop 0308
Oklahoma City, OK
73117-1299