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Arizona AIDS Drug Assistance Program (ADAP Assist)

The Arizona Department of Health Services (ADHS) is responsible for the administration of the AIDS Drug Assistance Program (ADAP) and ADAP Assist for the state of Arizona. ADAP/ADAP Assist provides access to medications used to treat HIV and prevent the onset of related opportunistic infections to low-income individuals with HIV disease who have limited or no insurance coverage.

Important News for ADAP Patients!
Working with a Case Manager to complete your application will help make sure a complete and accurate application is submitted and processed in a timely fashion.

Eligibilty  

Eligibility Requirements

Participants may be eligible for ADAP Assist when meeting all the requirements, click on the link below.

 
Documents Needed  

Required Documents

Participants will require to bring the documents listed when clicking the link below.

Prior Authorization Forms  

Application Process

You can get an application and assistance with filling out your application through your doctor, case manager, or health department. You can also download an application, complete it, and submit it yourself by mailing or faxing the application to ADAP, or bringing the application directly to the ADAP.

 
Formulary  

Prescriptions - Pharmacy Locations

You may continue to use Avella Specialty Pharmacy (formerly The Apothecary Shops) at (866) 881-4902 or www.avella.com each time you need a refill. Prescriptions can also be filled through any one of the participating pharmacies.

To locate the pharmacy closest to you, use the Pharmacy Locator on the left panel, or call Ramsell at 1-888-311-7632.
Formulary  

Formularies - Covered Medications
There is no set formulary for Arizona ADAP Assist. Arizona ADAP Assist pays the members copayment obligation. If the drug is not covered by the member's primary insurance, Arizona ADAP Assist will not cover the prescription. To download a complete list of medications, click on the link below.

 
Contact  

Contact Info

For more information and questions about ADAP, contact the ADAP Coordinator:

    Phone: (800) 334-1540 or (602) 364-3610
    Fax: (602) 364-32639
    Website: click here
    Request Form (Secure): click here!

Frequently Asked Questions

What Is the AZ ADAP?

ADAP Assist is co-pay assistance for ADAP clients who have PCIP, Medicare or private insurance. To qualify for ADAP Assist you must be HIV-infected, a resident of Arizona and have an annual income at or below 300% of federal poverty level.

Am I Eligible for ADAP Assist?

To qualify for ADAP Assist you must be HIV-infected, a resident of Arizona, not eligible for AHCCCS (Arizona's version of Medicaid) and have an annual income at or below 300% of federal poverty level (FPL).When we receive an ADAP application for a client who is insured or eligible for insurance, we ask for premium, formulary and co-pay information. ADAP needs this information to determine whether the coverage is adequate and affordable. Adequate means the insurance will cover the antiretroviral (ARV) drug therapy. Affordability is determined by adding the yearly premium and co-pays and comparing the total to the Health Resources and Services Administration (HRSA) affordability guidelines (see below). If the client's premium and co-pays for the year are more than 5 or 7% of their income, then the insurance is deemed unaffordable and the client is enrolled in ADAP Assist. If premium and co-pays are affordable, then the client will not be eligible for ADAP Assist.
  • 100-199% Federal Poverty Level (FPL) = 5% of annual income = affordability
  • 200-300% FPL = 7% of annual income = affordability

How Do I Enroll?

You can get an application and assistance with filling out your application through your doctor, case manager , or health department. You can also download an application, complete it, and submit it yourself by mailing or faxing the application to ADAP, or bringing the application directly to the ADAP.

Arizona Department of Health Services
150 N. 18th Ave Suite 110
Phoenix, AZ 85007
602-364-3610 (Phone)
602-364-3263 (Fax)

What Drugs Are Covered?

There is no set formulary for Arizona ADAP Assist. Arizona ADAP Assist honors the primary insurance's formulary and pays the member's copayment obligation. If the drug is not covered by the member's primary insurance, Arizona ADAP Assist will not cover the prescription.
ADAP Assist will not cover the following types of medication:
  1. 1. Contraception medicines or devices like birth control pills
  2. 2. Drugs for treatment of Erectile Dysfunction
  3. 3. Prescriptions used for cosmetic purposes
  4. 4. Fertility Agents

Where Can I Fill Prescriptions?

You may continue to use Avella Specialty Pharmacy (formerly The Apothecary Shops) at (866) 881-4902 or www.avella.com each time you need a refill. Prescriptions can also be filled through any one of the participating pharmacies. To locate the pharmacy closest to you, use the Pharmacy Locator on the left panel, or call Ramsell at 1-888-311-7632.

What is PCP?

The Pre-Existing Condition Insurance Plan (PCIP) is a health coverage option for people who have been without health coverage for at least six months, have a pre-existing condition, or have been denied health coverage because of their health condition, and are U.S. citizens or are residing in the U.S. legally. PCIP falls under the ADAP Assist umbrella. The difference with PCIP is that the program not only pays for medication co-pays, but also pays premiums and medical co-pays. In order to be eligible for PCIP, the client must be uninsured for the last six months and legally present in the U.S.

Are there any medications that require prior authorization under ADAP Assist?

Yes, Fuzeon, Valcyte, Lyrica, Egrifta and Serostim require a prior authorization under ADAP Assist. Please refer your physician to our website for prior authorization forms.
http://www.azdhs.gov/phs/hvstdhpc/adap.htm

Where Can I Learn More About Arizona ADAP?

Contact the Arizona ADAP Client Services at 602-364-3610 for more information about the program or visit our website.
http://www.azdhs.gov/phs/hvstdhpc/adap.htm

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