Eligibility, Enrollment Process and Provider Information
- Medical: HIV-infection or at risk of acquiring HIV infection consistent with the guidelines for Pre-Exposure Prophylaxis.
- Residency: New York State (U.S. citizenship is not required.)
- Financial: Financial eligibility is based on 435% of the Federal Poverty Level (FPL). FPL varies based on household size and is updated annually. Financial eligibility is calculated on the gross income available to the household, excluding Medicare and Social Security withholding and the cost of health care coverage paid by the applicant. Households cannot have liquid assets greater than $25,000. Liquid assets are cash, savings, stocks, bonds, etc. Liquid assets do not include car, home or federally recognized retirement accounts.
- Home Care: AIDS or HIV illness and chronic medical dependency due to physical or cognitive impairment from HIV infection.
A single application form can be used to enroll in ADAP, ADAP Plus, the HIV Home Care Program and PrEP-AP. An additional application is required for APIC. Applicants apply to the program, providing proof of residency, income and assets. A Medical Application signed by a licensed medical professional is required, verifying HIV status. A treatment plan by a physician must also be submitted for Home Care applicants. Upon determination of eligibility, an Enrollment Card is issued which may be used to receive care from an enrolled provider. The programs provide an automated eligibility verification system to allow providers to confirm participant eligibility status.
ADAP has enrolled over 3,100 local pharmacies statewide. Any pharmacy enrolled in the New York State Department of Health, Elderly Pharmaceutical Insurance Coverage Program (EPIC) and Medicaid is eligible to join the ADAP pharmacy network.
ADAP plusand PrEP-AP have enrolled over 205 Article 28 health care providers (over 270 service sites). These providers are hospitals, clinics and drug treatment programs who have been approved for participation in the Medicaid Program. A total of over 235 physicians have enrolled. Eligible physicians must be enrolled in the Medicaid Program. Over 50 laboratories are also enrolled to provide laboratory and ancillary services. Laboratories must be certified by the New York State Department of Health and participate in Medicaid.
The HIV Home Care Program has provider agreements with over 100 Home Health Agencies, Long Term Home Health Care Programs, Hospices and Licensed Home Care Services Agencies. Home Care agencies are screened through the New York State Department of Health Bureau of Long Term Care.