ADAP Medication Assistance provides many drugs on its formulary, including all anti-retroviral therapies approved by the U.S. Food and Drug Administration. Clients have a benefit cap of $2,000 per month, except for two drugs in Category V. This benefit is sufficient to support triple and quadruple combination therapies. These drug combinations have been successful in treating persons with HIV infection, including opportunistic infections frequently associated with HIV; have resulted in drug treatment adherence; and have helped to dramatically prolong the lives of people living with HIV.
Who is eligible for ADAP Medication Assistance?
Individuals must meet all of the following requirements:
- Diagnosed with HIV or AIDS and supply CD4 and viral load laboratory results not older than 6 months prior to enrollment.
- Currently live in Illinois and have a legal home address (domicile) in Illinois.
- Have anticipated gross annual income at or below 300 percent of the federal poverty level for household size. To view the current income levels click here.
- Verification of third party payer sources, such as Medicaid, Medicare or other commercial/employer based insurance if appropriate.
- In addition, the ADAP Medication Assistance enrollee’s health insurance company must participate with the ADAP Medication Assistance-contracted pharmacy for dispensing and billing purposes.
Who is not eligible for ADAP Medication Assistance?
Any of the following excludes an individual from ADAP Medication Assistance eligibility:
- Have an insurance policy with a prescription drug co-payment of less than 20 percent of retail price or less than $100 per prescription.
- Receive medical assistance through the Illinois Department of Healthcare & Family Services’ Medical Assistance Program on the date drugs are obtained. Individuals with a financial/medical assistance application pending or in a spend-down unmet status may participate in ADAP.
- Receive assistance through Social Security “Extra Help”.
ADAP Medication Assistance/ CHIC Premium Assistance hotline:
Please review these attachments/Web pages if you are interested in enrolling in ADAP Medication Assistance: