Whether or not you have insurance (even if your income is too high to qualify for Medicaid), there are still programs that can help.
The Affordable Care Act requires insurers to provide prescription drug coverage and they must cover at least one drug in every class (including HIV meds). Furthermore, they have to count your co-pays towards a lifetime cap on out-of-pocket expenses. The ACA marketplace has also made coverage available to millions of previously uninsured Americans — especially in states that accepted Medicaid expansion. Find more information at Healthcare.gov.
The federally created, state-managed AIDS Drug Assistance Program (ADAP) can also help pay for your HIV medications. The requirements vary by state, but typically you have to be a resident, have HIV, and earn less than a certain amount per year, calculated as a percentage of the federal poverty level.
Following is a guide to ADAP income requirements and contact information for every state. Each state’s Maximum Qualifying Income (MQI, the most you can make and still qualify for help) is shown as a percentage of the federal poverty level as well. We also give you the dollar amount for a one-person household, and you can use their charts to go up from there. Most states start with the 2016 federal poverty level for one person ($11,880 plus $4,160 for each additional family member).
