Updates to ADAP

Due to additional appropriations, the Florida Department of Health will expand services provided by the Ryan White Part B AIDS Drug Assistance Program (ADAP).

The expansion will cover the costs of HIV medications directly for individuals at or below 400% of the federal poverty level through June 30, 2026. Additionally, self-insured individuals and individuals receiving medication copay and deductible assistance through CVS Caremark will continue to be supported at or below 400% of the federal poverty level for HIV medication assistance.  

For assistance with your eligibility status, call your case manager or local county health department.

If you do not qualify for ADAP, contact your case manager. You may qualify for Partnership for Prescription Assistance and for patient assistance programs.

We encourage those in need to connect with available community resources to help with connection to care:

Patient Assistance Programs

Community, State, and Federal Resources

FAQs

Was additional funding provided to the ADAP Program?  

Yes, the Florida Legislature passed and Governor Ron DeSantis signed in to law HB 697 that provides an appropriation of $30,901,933 to the Florida Department of Health, to support an expansion of services provided by the Ryan White Part B AIDS Drug Assistance Program through June 30, 2026.   

Will this restore premium assistance for health insurance plans? 

No, this will not restore premium insurance assistance.  

Will I be able to receive insurance assistance for my employer sponsored plan? 

The program is no longer providing premium assistance, but if you are able to secure employer sponsored enrollment, you may be eligible to receive medication copay and deductible assistance. 

Will I be able to receive insurance assistance? 

The program is no longer providing premium assistance at this time, but if you are able to secure employer sponsored enrollment, you may be eligible to receive medication copay and deductible assistance. 

What is co-pay and deductible assistance, for medication? 

Medication copay and deductible assistance is a program that provides assistance with Medication Copays and deductibles that clients are typically responsible for at the pharmacy. 

I purchased my own insurance; can I still receive direct dispense medication? 

No, but you may be able to receive medication copay and deductible assistance.  

My employer is paying for my insurance; can I still receive direct dispense medication? 

No, but you may be able to receive medication copay and deductible assistance. 

When were letters sent and who issued them? 

The Department issued letters on March 24, 2026 about the updated eligibility information and direct dispense availability. If you have not received a letter and you were previously eligible, please contact your local case manager.

For any questions regarding the direct medication services and to enroll, please contact Prime Therapeutics, LLC., at 833-604-0925.  

Can I still enroll in the Special Enrollment Period (SEP)? If so, how? 

Yes, CMS has announced a special enrollment period for individuals affected.

Is Descovy still covered? 

Yes, but it is expected to change as of April 1,2026, requiring a prior authorization for individuals with renal failure with CrCl <60 . 

Is Biktarvy still covered? 

Not for direct dispense but it is covered for self-insured individuals only. There are two separate formularies for uninsured and self-insured individuals, this can be found FLHealth.gov/ADAP 

Is Cabenuva still covered? 

Yes, please reference both updated self-insured and uninsured formulary lists.

What is CVS Caremark?  

CVS Caremark is the contracted Pharmacy Benefit Manager (PBM) for medication copay assistance.  

Who qualifies for medication copay assistance? 

Any client that is enrolled in Medicare, ESI, COBRA, ACA, or self-insured with a federal poverty level, between 0 – 400% is qualified. 

Can I go to a Ryan White Part A provider? 

Yes.

What is the new eligibility federal poverty level? 

For self-insured individuals the FPL requirement remains 0 – 400% for Medication Copay Assistance Only. 

For uninsured individuals the new eligibility FPL requirement has expanded to 0 – 400% direct dispense medication assistance. 

Where can I go to get my medication? 

For any questions regarding the direct medication services and to enroll, please contact Prime Therapeutics, LLC., at 833-604-0925.

Where can I go to be seen by a doctor? 

If you are uninsured, reach out to your local case manager or county health department for assistance.  

If you are self-insured, you can contact your carrier for an in-network provider list. 

How can I check my eligibility status? 

To check your Ryan White Part B eligibility status, you can contact your local county health department or the program’s Helpdesk at 844-381-2327. 

Where is my local case manager? How do I contact them? 

Call your local county health department for more assistance. 

How can I see a doctor? 

If you are uninsured reach out to your community-based organization or county health department for assistance. 

If you are self-insured, you can contact your insurance carrier for an in-network provider list. 

I am eligible with the expansion and was previously enrolled in ADAP prior to the March 1 changes. Do I need to re-enroll? 

No, clients that were previously eligible and enrolled in ADAP will automatically re-enroll. 

The AIDS Drug Assistance Program (ADAP) is a statewide, federally-funded prescription medication program for low-income people living with HIV. This program provides access to medications to eligible clients either directly or self-insured individuals and individuals receiving medication copay and deductible assistance through CVS Caremark.

STEP 1: Eligibility and Verification

You may be eligible for ADAP assistance if the following applies and proof is provided:

  • HIV positive status
  • Need HIV/AIDS medications
  • Income at 400% of the Federal Poverty Level
  • Are uninsured or do not have adequate prescription coverage
  • Are not confined to a hospital, nursing home, hospice, or correctional facility

You can apply for assistance online. You must complete and submit an Application to Receive Allowable Services to apply for services. You will need to also contact your local ADAP office for more information.

Schedule your ADAP appointment

Once you have been determined eligible, please be sure to bring the eligibility letter with you to the appointment for enrollment.

Call your local county health department and speak with an ADAP program staff member.

OR

Call the ADAP Help Desk at 844-381-2327.

If you do not qualify for ADAP, contact your case manager. You may qualify for Partnership for Prescription Assistance and for patient assistance programs.

There are over 180 programs offered by pharmaceutical companies that provide free or low-cost drugs for individuals who cannot afford to pay for them. Each program has specific eligibility criteria and coverage.

STEP 2: Enrollment

Enroll in ADAP

Once you have been determined eligible and scheduled your ADAP appointment (Step 1), you can move forward with ADAP enrollment. You will need to provide:

  • Patient Care Core Eligibility Form
  • Prescription for at least one antiretroviral
  • Insurance documentation, if applicable (see below)

ADAP Insurance

ADAP clients with income of at least 50% of the federal poverty level may qualify for assistance with insurance through the federal marketplace.

In addition to meeting the program qualifications, an individual must meet the following criteria to receive ADAP Insurance:

  • Be enrolled in an ADAP supported insurance plan
  • Use a pharmacy in the network of the ADAP contracted pharmacy benefits manager to receive medication co-payments and/or deductible assistance
  • Use the ADAP-contracted insurance benefits manager to enroll and receive insurance premium assistance

Medicare Assistance

If you are a Florida resident who recently turned 65, you may be eligible for Medicare. Don’t be intimidated by the process, the Florida Department of Elder Affair’s Florida SHINE can help.

  • Request determination of subsidies from the federal marketplace when submitting a marketplace application
  • Provide all supporting documentation required at the time the federal marketplace application is submitted and the enrollment is processed

ADAP insurance offers help with the following types of insurance:

  • Medicaid share-of-cost: if the cost of medications is not enough to activate share-of-cost Medicaid each month
  • Medicare Part C or Part D: co-pays only
  • Employer-sponsored insurance
  • COBRA policies
  • Annually approved ADAP supported plans: in the federally marketplace.

ADAP cannot pay for a stand-alone dental or vision insurance policy. ADAP cannot pay out-of-pocket costs for any service except pharmacy costs.

For more information on health care insurance coverage through ADAP, please contact your local ADAP office.

STEP 3: Getting Prescriptions Filled

A complete list of drugs that ADAP provides can be found on the  Florida ADAP formulary.

  • Uninsured clients in a county health department that has no onsite pharmacy will be served through a specialty pharmacy.
  • Clients with insurance will pick up medications from a CVS retail store or a participating pharmacy.

A valid form of identification will be needed in order to pick up prescriptions. Make sure you take your medications as prescribed by your doctor. For more information about medications the program carries, please refer to the ADAP Formulary.

Specialty Pharmacy

ADAP has partnered with CVS Specialty Pharmacy to enhance the way our uninsured clients receive their medications. CVS Specialty Pharmacy is not a local CVS store. It is a mail-order pharmacy located in Pennsylvania. ADAP prescriptions will be filled at this pharmacy and sent to a location of the client’s choosing.

  • Have your medications delivered to your home or other address
  • Pick up your medications at a CVS retail store during their normal business hours
  • Pick up your medications from your county health department during their normal business hours
CVS Specialty red logo

Check with your local ADAP office to make sure your information is up to date. You’ll also need to update your communication choices to allow ADAP and CVS Specialty Pharmacy to contact you by phone. CVS Specialty calls each client before a medication shipment is made to alert the client the date medications will be shipped, the address is correct, and the client will be available to receive and sign for the medications.

The caller ID from CVS Specialty will be 800-498-2037 or 800-238-7828. Clients may also call this number if they have any questions.

Uninsured ADAP clients who receive medication services in these counties will not be affected:

  • Broward
  • Duval
  • Hillsborough
  • Miami-Dade (except for clients served by West Perrine Clinic)
  • Sarasota

If you have questions or concerns, or if you’re not sure if this affects you, please contact your local ADAP office or ADAP’s central office at 844-381-2327

SAME DAY Program

The SAME DAY program was initiated for uninsured clients to have immediate access to most medications and vaccines that needed to be started on the same day or soon after the prescription is written. If you are an uninsured ADAP client, you can use the SAME DAY card to get certain prescription medications and vaccines you need right away at more than 68,000 participating stores.

  • SAME DAY drugs must be on the ADAP formulary
  • Your provider must send your SAME DAY prescription to a participating pharmacy
  • You must present your SAME DAY ID card at the pharmacy
  • Program does not cover HIV antiretroviral or hepatitis drugs
  • Vaccines may not be available at all locations – contact your pharmacy to confirm
  • Program does not replace CVS Specialty services – regular medications from CVS Specialty will continue
CVSHealth Same Day Card sample

Getting a SAME DAY ID Card

You will need a SAME DAY ID card to use these services. CVS will mail you your SAME DAY ID card. If you haven’t received it or need a replacement, your local ADAP office can print one for you.

Check out our printable SAME DAY palm card for quick information on using the program. This is not a SAME DAY ID card.

For more information, call the ADAP state health office at 844-381-2327, Monday through Friday, 8 a.m. – 5 p.m. Eastern time.

ADAP SAME DAY is intended to offer flexibility for ADAP clients. Ryan White Part A or Part B and other local assistance programs can keep using local processes to provide same-day medications.

Quarterly and Annual Reports

Quarterly Reports

Annual Reports

Program Assistance
  • Call your local county health department and speak with an ADAP staff member
  • Call the ADAP Help Desk at 844-381-2327
  • Call the Florida HIV/AIDS Hotline:
    • English: 800-352-2437 (800-FLA-AIDS)
    • Spanish: 800-545-7432 (800-545-SIDA)
    • Haitian Creole: 800-2437-101 (800-AIDS-101)
    • TTY: 888-503-7118
ADAP Medication ADAP Formulary Workgroup
Membership Application
Workgroup Charter

The ADAP drug formulary is a listing of all medications that are covered by the program for all eligible clients, whether insured or uninsured. If a medication is not listed on the drug formulary, then the insurance or assistance program will not cover the medication costs.

Trogarzo

Trogarzo is a CD4-directed post-attachment HIV-1 inhibitor for people living with HIV who have tried multiple HIV medications in the past and whose HIV has not been successfully treated with other currently available therapies. Trogarzo is administered intravenously once every 14 days by a medical professional and must be used in combination with an optimized background regimen containing one or more antiretrovirals with activity against the virus.

Trogarzo is available to a limited number of eligible ADAP clients through a prior authorization process sent to the department’s medical team, and access will be coordinated through Thera Technologies’ distribution network for ADAP clients.

Workgroup Meetings and Minutes