What is ADAP? (Spanish, Chinese)
ADAP is a prescription drug benefit that pays for many drugs for the treatment of HIV/AIDS, including anti-retroviral, anti-neoplastic, opportunistic infection therapies, and prophylaxis for pneumocystis carinii pneumonia (PCP). ADAP will pay the full cost of drugs it covers if you have no health coverage.  ADAP also helps pay co-payments and deductibles when your private insurance or Medicare Part D does not.  It will also pay for medications not covered by your insurance if the medication is listed as a covered drug under ADAP.  ADAP can assist individuals who are awaiting a Medicaid eligibility determination.  If you have a Medicaid spenddown because your income is above Medicaid’s limit, ADAP will also help pay your spenddown (for more information on spenddown, see CIDNY’s Medicaid page.

Will it cost me anything?
No.  The purpose of the ADAP program is to provide free HIV/AIDS drugs to low-income individuals who are not covered by Medicaid or other health insurance.
 
Who is eligible? 
People are eligibile if they have low-income, are HIV positive or living with AIDS, and are uninsured or underinsured. Financial eligibility is on a sliding scale based on income and household size. 
Eligible income for a household of one is $44,000 a year; for two, $59,200; and for three or more, $74,400. 
Households cannot have “liquid” assets greater than $25,000.  Your car and your home do not count as liquid assets for this purpose.  

What documents do I need to apply?
A physician’s statement signed by a licensed medical professional verifying HIV-infection and indicating your medical status.


Proof of residency present one of these (U.S. citizenship is not required):

  • Rent receipt
  • Lease
  • Driver’s license
  • Fuel/utility bill
  • Voter registration card

To prove your income, you must submit the following:

If you are employed:

  • Pay stubs for the previous 30 days or
  • Notarized letter from your employer stating gross pay for the past 30 days
     And a copy of the previous year’s income tax return
If you are self-employed:
  • Business records for the three months before you apply, indicating type of business, gross income, net income, and the income tax return for prior year.  A notarized statement of current annual income is also necessary.


If you are not employed, send proof of income you receive, including copies of:

  • unemployment checks
  • Social Security checks
  • pension checks

 Proof of liquid assets, which cannot be greater than $25,000.00.  Liquid assets include:

  • Cash
  • Savings
  • Stocks
  • Bonds, and
  • Pre-tax retirement savings, which will be counted as 50 percent of its cash value.


Do I have to enroll with Medicare Part D before applying for ADAP?
If you are eligible for Medicare or a comprehensive health insurance (full medical and prescription coverage), then you must apply for Medicare Part D if your present coverage is not equal to or better than Medicare Part D.  Your current insurer should send you a letter telling you whether their coverage meets this standard.  After you have applied to Medicare Part D, you can apply for ADAP if you need extra coverage.

Why do I have to enroll for Medicare Part D? 
The ADAP program is federally funded to pay for HIV/AIDS prescriptions that no other programs will cover.  Since Medicare covers prescriptions drugs,
you must enroll in Medicare Part D first if you qualify for Medicare.

Where do I apply for ADAP?
You can call 1-800-542-2437 from within New York State.  From out of state, call (518) 459-1641, TDD: (518) 459-0121, or write ADAP at:

New York State Department of Health
AIDS Institute
Empire Station
P.O. Box 2052
Albany, NY 12220-0052. 

or download the application the application is also available in spanish.

How long will it take to find out if I am eligible? 
Applications submitted with all required documentation are processed within two weeks.  When your application is approved, you will get an Eligibility Card and instructions on how to use it. You must present this card and your prescription at a pharmacy that accepts ADAP in order to receive covered medications at no charge. 

Where can I find out more?
Call ADAP at 1-800-542-2437 or 1-518-459-1641.

Getting Help
If you need help applying for or accessing your ADAP coverage, call CIDNY at 646-442-4186 and ask to speak to a benefits counselor.