The Florida ADAP may pay health insurance costs instead of buying medications for clients. ADAP assists with some premiums and with out-of-pocket costs for drugs on the program formulary. Out-of-pocket costs can be deductibles, co-pays, coinsurance or similar costs for Medicare Part C or D. Health insurance assistance funded through ADAP is part of ADAP, not a separate program. All ADAP clients must be eligible to receive any service.
ADAP is part of the Ryan White HIV/AIDS Program, which directs ADAP how to buy insurance. ADAP must pay less for the health insurance costs than it would cost to buy the medications directly. The U.S. Department of Health and Human Services publishes Clinical Guidelines about treating HIV. The Guidelines list similar drugs in groups called classes. When ADAP pays the costs of health insurance, the plan must include at least one drug in each class. The plan must provide both primary care and treatment of HIV. ADAP cannot pay for health insurance that does not include a pharmacy benefit. For example, ADAP cannot pay for a stand-alone dental or vision insurance policy. ADAP cannot pay out-of-pocket cost for any service except pharmacy costs. However, other programs of the HIV Section may be able to help with those costs.
For more information on healthcare insurance coverage through ADAP, please contact your local ADAP Office.