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Virginia Department of Health Pharmacy Benefit Management Program

The Virginia (VA) AIDS Drug Assistance Program provides access to life-saving medications for the treatment of HIV and related illnesses for low-income clients through the provision of medications or through assistance with insurance premiums and medication copayments. The program is primarily supported with federal Ryan White (RW) Treatment Extension ActPart B grant funding, which is distributed by a formula based on living HIVand AIDS cases to all states and territories in the United States. VA ADAP provides insurance cost support or directly purchased medications through four service options: Direct ADAP, the Medicare Part D Assistance Program (MPAP), the Insurance Continuation Assistance Program (ICAP) and the Health Insurance Marketplace Assistance Program (HIMAP).

Frequently Asked Questions

Am I Eligible for ADAP Assist?

To be eligible for one of the programs supported by Virginia AIDS Drug Assistance Program (ADAP) applicants/clients must:

  1. 1. Live in Virginia
  2. 2. Apply through Virginia Department of Health (VDH) Central Office or through Virginia Commonwealth University Health Systems (VCUHS) Financial Services
  3. 3. Have an individual or family income at or below 400% of the Federal Poverty Level
  4. 4. Have documented CD4 count(s) and Viral Load(s) within the last six months
  5. 5. Not qualify or have Medicaid
  6. 6. Provide proof of income, changes in insurance coverage or any changes in residency every six months for recertification
  7. 7. Agree to participate in the service option that best meets the client' needs and resources, and for which the applicant/client is eligible

Eligibility requirements can be viewed at:
> http://www.vdh.virginia.gov/disease-prevention/eligibility/

How Do I Enroll?

There are two options to complete an application:

  1. 1.Complete the entire application and mail and/or fax to the ADAP Central Operations Office (Fax 1-804-864-8050, Toll Free Fax 1-877-837-2853, Mailing address: Virginia Department of Health, Eligibility, HCS Unit, 1st Floor, James Madison Building, 109 Governor Street, Richmond, VA 23219). The application can be found on-line at: http://www.vdh.virginia.gov/disease-prevention/eligibility/

  2. 2. Call the Medication Eligibility Hotline (1-855-362-0658), and staff will help with the application process. The application will be mailed to the listed mailing address to sign and provide documents verifying income. The application can be returned to VDH in the postage-paid envelope that will be included.

What Drugs Are Covered?

HIMAP (also referred to as ACAIC)

Clients enrolled in a VDH-approved HIMAP/ACAIC plan will receive copayment assistance for all medications on the insurance plan's formulary.

ICAP

Clients enrolled in ICAP will receive copayment assistance for medications only on the Virginia ADAP and non-ADAP formularies.

VA ADAP Formulary:

http://www.vdh.virginia.gov/disease-prevention/formulary/

VA Non ADAP Formulary:

http://www.vdh.virginia.gov/disease-prevention/formulary/

MPAP

Clients enrolled in a MPAP will receive copayment assistance for all medications on the client's Medicare Part D formulary.

Where Can I Fill Prescriptions?

To locate the pharmacy closest to you, enter your City, Zip code or County in the Pharmacy Locator on the left panel. Or call Ramsell at 1-888-311-7632.

Where Can I Get More Information About VA ADAP?

More information can be found on the Virginia Department of Health website:
> http://www.vdh.virginia.gov/disease-prevention/virginia-aids-drug-assistance-program-adap/

Other Documents

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