![]() Each state operates its own ADAP, including determining eligibility criteria and other program elements, such as formularies, resulting in significant variation across the country. Many states also use ADAP funds to help clients pay for the cost of health insurance. It helps covers the cost of HIV-related prescription medications for low- to moderate- income people who have limited or no prescription drug coverage. The AIDS Drug Assistance Program (ADAP) is part of Ryan White. The program may also be able to help with the cost of things like insurance premiums, cost-sharing, and the cost of medication. It covers outpatient HIV care and treatment for those without health insurance and helps fill coverage gaps for those with insurance. The Ryan White HIV/AIDS Program is a federal program specifically for people living with HIV. Website: /service-details/hiv-information-for-the-public The amount of any financial assistance will also be estimated when you purchase marketplace coverage. ![]() To see if you may be eligible for financial assistance in the marketplace, click here to use the Kaiser Family Foundation subsidy calculator. To enroll, go the website (or call the helpline) listed above.įinancial assistance may be available to help with monthly premiums and out-of-pocket costs. If you qualify for Medicaid or the Children’s Health Insurance Plan (CHIP) you can enroll at any time. People with lower incomes or certain life changes may be able to enroll or change plans at other times of the year. Individuals may purchase coverage in the Marketplace during the open enrollment period, a specific time period at the end of the year, to begin the first of the year following. Health plans sold outside of the Marketplace may not offer the same protections or comprehensive benefits. ![]() Marketplace plans also are required to provide a minimum set of “Essential Health Benefits,” including prescription drugs, doctors visits, hospital care, mental health care and certain preventative services, including HIV testing and PrEP. Individuals purchasing coverage through the marketplace cannot be denied or charged more for coverage because of a pre-existing condition, including HIV or COVID-19. Those that do not have affordable coverage from an employer or other source may be eligible for subsidies to make it more affordable. Under the Affordable Care Act (ACA), Health Insurance Marketplaces are available in every state where individuals can buy coverage on their own.
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