- Live in Pennsylvania,
- Have a gross annual (household or individual) income of less than or equal to 500% of the federal poverty level,
- Have a diagnosis of HIV, and
- Not be eligible for pharmacy services under the Medical Assistance (Medicaid) Program.
Make an account, and fill out the online application.
You can also download an application. (Spanish version link) Submit completed application and copies of documentation to:Special Pharmaceutical Benefits Program
P.O. Box 8808
Harrisburg, PA 17105-8808
Or email to: SPBP@magellanhealth.com
Or fax to: 888-656-0372
For questions about the application or enrolling, call 1-800-922-9384 or send your questions to SPBP@pa.gov.
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
Link to Government Site:
Pennsylvania Department of Health, Special Pharmaceutical Benefits Program
625 Forster Street H&W Bldg, Rm 611Harrisburg, PA 17120