Benefits & Insurance

AIDS Drug Assistance Program (ADAP)

The Program

The AIDS Drug Assistance program (ADAP) is a national prescription drug program that was initiated by the federal government in April 1987. ADAP was created to provide free or low cost HIV drugs for HIV infected persons with limited financial resources. Initially ADAP was established to assist eligible participants with cost of Zidovudine, or AZT. AZT was the first drug approved by the United States Food And Drug Administration for the treatment of HIV disease. The initial annual cost of AZT was about $10,000 per person.  As HIV treatment advances occurred, the program was expanded to cover the costs of additional medications.  In 1990, ADAP was folded into the newly enacted Ryan White CARE ACT Legislation.  Since 1990, The Ryan White CARE Act has been reauthorized twice in 1996, 2000 and recently in 2006.

From the beginning of the program, the federal government authorized administrative responsibility to the states. The states were also granted authority to establish their own medical and financial eligibility standards. Currently all 50 states, as well as the District Columbia, Guam, the U.S. Virgin Islands and the Commonwealth of Puerto Rico, have instituted ADAP programs.

In California, ADAP was established soon after the national initiation of the benefit.  Currently, California has one of the most generous ADAP plans in the country.  The California ADAP formulary (list of available drugs) covers over 140 medications.  This formulary includes medications for the treatment of depression, diabetes and anxiety, as well as for the management of HIV infection.

The Ramsell Corporation administers the California ADAP program via its subsidiary, Public Health Service Bureau (PHSB), and is under contract with the California Department of Health Services. PHSB is responsible for payment and coordination of services as well as client enrollment and inquires.  PHSB can be reached toll free at 1.888.311.7632. Both consumers and providers interested in ADAP are encouraged to call.  Click here to visit PHSB on the Web.

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Eligibility In California

To be eligible for the California ADAP program applicants must:

• Be living in California. Special note: applicants are not required to be United States citizens or legal permanent residents.  Legal residency in the United States is not required for participation in the ADAP program.
• Be at least 18 years of age
• Be HIV-positive
• Have a federal adjusted gross income of less than $50,000 a year. See levels of coverage for more information.

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Enrollment

In the Los Angeles Area applications are accepted at the following locations, including ADAP applications from the general public.

• AIDS Project Los Angeles, The David Geffen Center, 611 South Kingsley Drive., Los Angeles, CA  90005 - 213.201.1365
• Catalyst Foundation - Lancaster - 661.948.8559
• H. Claude Hudson Comprehensive Health Center - 213.744.3565
• Jeffrey Goodman Special Care Clinic-Hollywood - 323.993.7500
• St. Mary's Medical Center, CARE Clinic-Long Beach - 562.491.9999
• Tarzana Treatment Center - Lancaster - 661.723.4829
• Tarzana Treatment Center - Tarzana - 818.996.1051x188

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The following organizations accept ADAP applications only from registered or participation clients:

• AIDS Healthcare Foundation-Downtown - 213.763.4210
• AIDS Healthcare Foundation-Hollywood - 323.662.0492
• AIDS Healthcare Foundation-North Hollywood - 818.508.2555
• AIDS Healthcare Foundation-West Side - 310.657.9353
• High Desert Hospital-Lancaster - 661.945.8448
• Alta Med-East LA - 323.869.5448
• LAC & USC Medical Center - 213.226.2090
• Kaiser Permanente-Los Angeles - 323.783.4148
• Kaiser Permanente-West LA - 323.857.3315
• Children's Hospital - 323.669.2390
• East Valley Community Health Center - Pomona - 310.761.8442
• Harbor UCLA Medical Center - Torrance - 310.222.2365
• Martin Luther King Jr. Hospital/Oasis Clinic, LA - 310.668.3802
• Watts HealthCare Center - 323.568.3010

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Documentation

The following documents are required in order to apply for ADAP:

• Proof of California Residency - Utility bills, rental agreements, vehicle registration, leases or mortgages will suffice as proof.
• Picture Identification - California drivers license or ID, passport, school ID or disabled bus pass are all acceptable.
• Proof of Income - Copies of federal and state income tax returns including corresponding W-2 or 1099, most recent pay stubs, public assistance benefits verification letters or social security award letters.
• Letter of Diagnosis - A letter from a licensed physician is required as verification of HIV infection showing most current CD4 counts and viral load (within 6 mo.).

If the above documents are not available at the time of application, RAMSELL is authorized to provide a 30-day temporary supply of medications.  This temporary eligibility should allow enough time for the needed documents to be obtained.  These documents will need to be presented to the enrollment counselor before the 30-day time limit expires for continued eligibility.         

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Levels of Coverage

Participants with federal adjusted gross incomes of less than $41,600 (or 400 percent of federal poverty) are eligible for full coverage.  Full coverage provides access to all medications on the ADAP formulary free of charge.  Medications must be prescribed by a licensed physician and must be purchased at an ADAP participating pharmacy.  Most Rite-Aids, Sav-on and Von's pharmacies participate.  Contact RAMSELL or your pharmacy to find out if your pharmacy participates.

Applicants with federal adjusted gross incomes of between $41,600 and $50,000 may be eligible for partial assistance with the cost of their HIV medications.  Participants with incomes in this range are required to pay a monthly co-payment towards the costs of their medications. Co-payments are calculated based on income, number of dependents (if any), whether or not the applicant has other private health insurance and other qualifying factors.  Certain restrictions may apply and are explained at the time of application by the ADAP enrollment counselor.

Participants with federal adjusted gross incomes of greater than $50,000 are not eligible for ADAP assistance in California.

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ADAP Additional Services

Medicare & ADAP - People with Medicare are able to use ADAP to pay their monthly premiums and/or co-pays.

Medi-cal only recipients are ineligible for the ADAP program. 

Clients with VA benefits are ineligible for the ADAP program.

Private insurance & ADAP - Clients with private health insurance who also meet ADAP program eligibility requirements are able to access a service that pays for co-payments for the prescription medications listed on the ADAP formulary.  Using ADAP services in conjunction with private health insurance can effectively eliminate any out of pocket expenses related to HIV medications regiments. Clients with private health insurance are encouraged to apply for ADAP assistance.

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Special Program Notes

ADAP & other health insurance coverage - ADAP works in conjunction with all other types of health insurance coverage.  Enrollment in Medicare a Medicare HMO, Medi-Cal, and/or private health insurance do not affect eligibility in the ADAP program.

ADAP & CARE HIPP (Comprehensive AIDS Resources Emergency ACT, Health Insurance Premium Payment Program)- CARE HIPP pay s for health insurance premiums for eligible HIV infected individuals. People who receive CARE HIPP assistance are eligible for ADAP services.  If clients are receiving CARE HIPP they are most likely enrolled in a private health insurance program.  This means that they are eligible for the co-payment assistance only.

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More Information

RAMSELL can handle most public inquiries about the ADAP program.  Provides or clients needing more specific policy information should contact the California State Office of AIDS (SOA) at 919.445.0553.  Click here to visit SOA on the Web. Interested parties are also encouraged to contact eh HIV/AIDS Bureau of the Health Resources and Services Administration (HRSA) HRSA's HIV/AIDS Bureau is the federal office responsible for implementing and overseeing the Ryan White CARE Act.  Click here to visit HRSA's HIV/AIDS Bureau on the Web.

If you have questions about APLA, becoming a client or about any of the services we offer, call us at 213.201.1600 during normal business hours or send an e-mail. We are happy to help.

The Get Help section of this Web site includes:

• Eligibility Requirements for Programs & Services
• Programs & Services
• Registration Forms