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The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

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Eligibility Information

HIV/AIDS

What are the eligibility requirements?
  • You have to be HIV positive.
  • You must be living in Florida.
  • You cannot be receiving the same services from Medicaid, or Insurance.
  • You have to be low-income – at or below 400 percent of the Federal Poverty Level (FPL).

Can I apply or recertify for eligibility online?
  • You can fill out some of the forms online. By submitting these electronic forms, you understand that these forms may be received by the Florida Department of Health and/or lead agencies contracted with the Florida Department of Health to provide case management and eligibility services as well as their subcontractors.
  • You will need to agree for us to send your eligibility information securely for us to help you.
  • You will need to tell us the county where you want to receive services.
  • Someone in your area will contact you after you fill out the forms. The forms give you the option to choose who this will be, but you can also leave this blank.
  • You should call your local consortia if you need help with the online forms or have questions.

What services are covered?
  • Doctor visits
  • Dental care
  • Transportation
  • Health insurance premiums
  • Case management
  • Prescriptions
  • Housing
  • Other support services

If I am determined eligible, can I receive all these services?
Not necessarily. The services have to be available and funded. In addition, there are program qualifications to participate in these single-service programs:
  • AIDS Drug Assistance Program (ADAP)
  • State Housing Opportunities for Persons With AIDS (HOPWA)


What documentation is required?

  • Proof of HIV status - Original or copy of an HIV laboratory test that shows your HIV status. A doctor’s statement will not work.
  • Proof of living in Florida. Provide photo ID, if possible.
  • Any documents that show you have insurance, are receiving services from other programs, or have been denied, such as:
        - Medicaid card
        - Medicare card
        - Insurance policy
        - Public assistance program award or denial letters
        - Veterans Administration
  • To show your income, all of the following that apply:
        - Current pay stubs
        - Military and earnings statement
        - Proof of rental and other income
        - 1040 if self employed
        - Public assistance award or denial letters


What if I don’t have all the documentation?
It’s okay. Include what you have or call your local office for help. Having the correct information when you apply will speed up your eligibility determination.


What happens after I apply?
Once your application and documentation is received, eligibility staff will schedule an interview to review your application. You may be asked to submit more information.


When will I start receiving services?
Eligibility staff will give you an eligibility confirmation letter after your application is processed and approved. You will be asked to choose a case management agency to help you determine your needs and/or you may be referred to one of the single-service programs for drug, housing, or insurance assistance, depending on your situation.


What if I am not eligible and I don’t like the decision?
You will receive a written letter explaining why you are not eligible as well as information about your right to ask for a fair hearing.


How do I apply?
You will need to call your local consortia for contact information.

FLORIDA HIV/AIDS RYAN WHITE PART B ELIGIBILITY PROCEDURES MANUAL

 
Attachments

All files are pdf/doc format and under 5mb in size. All files open in a new window

Attachment

Name

Requirement

List of Attachments

Attachment Summary

N/A

Attachment A

Ryan White Program Definitions of Eligible Services

N/A

Attachment B

DH 1120, Acceptable Use and Confidentiality Agreement

Required

Attachment C

Core Eligibility Requirements Brochure (English, Spanish, and Creole)

N/A

Attachment D

DH 150-884, Eligibility Application

Required

Attachment E

Eligibility Staff Assessment Worksheet

Required

Attachment F

Six Month Re-Determination Review Form

Required

Attachment G

DH 8000-PHSPM, Notice of Eligibility

Required

Attachment H

Notice of Ineligibility

Required

Attachment I

Insurance Waiver Form

Required

Attachment J

Self Employment Tracking Sheet

Required