AIDS Drug Assistance Programs
The AIDS Drug Assistance Programs provide medications to lower-income HIVers who are either uninsured or underinsured. The programs are both federally and state-funded and are administered by state governments. So as with Medicaid, there is a wide disparity in what's available to HIVers depending on where they live. Income cutoffs range, for example, from 125% of the federal poverty level in North Carolina to 500% in states such as Massachusetts and New Jersey.
An ADAP is meant to be the payer of last resort, meaning that if you qualify for any other source of drug coverage, such as COBRA or VHA care, you must access that first. If you cannot afford premiums on an alternative source of drug coverage, however, keep in mind that 26 state ADAPs in 2004 used a program called CARE/HIPP to subsidize many clients' premiums, rather than directly paying for their drugs. Also, if there are gaps in your coverage elsewhere, ADAP may be able to help.
In the current political climate ADAPs are especially strapped for cash. Across the country the program needs an estimated $300 million in new funds for 2006, but Congress is on track to approve only $10 million. Consequently, 17 ADAPs don't provide all 20 antiretrovirals, and South Dakota does not provide any at all. On the flip side, New York has nearly 500 medications available and is unusual in that it also offers reimbursement for more comprehensive medical care.
Locate your state ADAP at www.atdn.org or call the AIDS Treatment and Data Network at (212) 260-8868.
Patient Assistance Programs
Pharmaceutical companies are ramping up efforts to provide free medications to low-income uninsured Americans. Their patient assistance programs are good news for HIVers, especially considering that all the major antiretroviral drugs are available. A new Web site created by a coalition of companies called the Partnership for Prescription Assistance is a one-stop resource to find out if you qualify for a program and how to get an application to receive free meds. Keep in mind that you need to have a prescription for the drug or drugs before you start this process. And because these programs are run by individual companies'this site merely acts as a gateway'you will need a separate application for each prescribed medication. If you don't qualify, the site's representatives can help guide you to other public programs, such as ADAP or Medicaid. Find the reference site at www.pparx.org or call (888) 477-2669.