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Contact us for assistance with how to enroll in our programs, how to locate a pharmacy or document, or any other need you may have.

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Arizona AIDS Drug Assistance Program (ADAP Assist)

The Arizona Department of Health Services (ADHS) administers ADAP for the state of Arizona. ADAP 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 coverage from private insurance or Medicaid. ADAP Assist is co-pay assistance for ADAP patients who have private insurance or Medicare.

Important News for ADAP Patients!
Working with a Case Manager to complete their 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.

 
Formulary  

Formularies - Covered Medications
There is no set formulary for Arizona ADAP Assist. Arizona ADAP Assist will not cover the prescription if it's not covered by the member's primary insurance. ADAP Assist will not cover the following types of medication:
  1. 1. Contraception meds or devices for birth control
  2. 2. Drugs for treatment of Erectile Dysfunction
  3. 3. Prescriptions used for cosmetic purposes
  4. 4. Fertility Agents
Prior Authorization Forms  

Application Process

For assistance in enrolling in Arizona ADAP, you must contact an ADAP Case Manager in their area and complete the ADAP Application form.

  
Prior Authorization Forms

Prior Authorization Forms

Click on the link below to download a Prior Authorization Form.

Formulary  

Other Documents

Note: some of the documents below can only be accessed via the secure site.

  
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
    Email: memberservices@ramsellcorp.com
    Request Form (Secure): click here!

Frequently Asked Questions

What Are the Enrollment Requirements for ADAP Assist?

To qualify for ADAP Assist clients 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

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

What Prior Authorization Forms Are Required?

Where Can Prescriptions be Filled?

Clients 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, or call Ramsell at 1-888-311-7632.

Where Can I Learn More About Arizona ADAP?

Please call toll free at (800) 334-1540 (in-state only), or (602) 364-3610. Please ask to speak to the ADAP coordinator.

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