The Illinois AIDS Drug Assistance Program (ADAP)

ADAP provides 80 different drugs on its formulary, including all anti-retroviral therapies approved by the U.S. Food and Drug Administration. Clients have a benefit cap of $2,000 per month, except for two drugs in Category V. This benefit is sufficient to support triple and quadruple combination therapies. These drug combinations have been successful in treating persons with HIV infection, including opportunistic infections frequently associated with HIV; have resulted in drug treatment adherence; and have helped to dramatically prolong the lives of people living with HIV.

Who is eligible for ADAP?

Individuals must meet all of the following requirements:

• Diagnosed with HIV or AIDS.
• Currently live in Illinois and have a legal home address (domicile) in Illinois.
• Have anticipated gross annual income at or below 300 percent of the federal poverty level for household size. To view the current income levels for 300% federal poverty level visit: http://www.idph.state.il.us/health/aids/adap.htm.

In addition, if an ADAP enrollee has health insurance, the health insurance company must participate with the ADAP-contracted pharmacy for dispensing and billing purposes and only drugs on the ADAP formulary will be covered.

Who is not eligible for ADAP?

Any of the following excludes an individual from ADAP eligibility:

• Have an insurance policy with a prescription drug co-payment of less than 20 percent of retail price or less than $100 per prescription.
• Receive medical assistance through the Illinois Department of Healthcare & Family Services’ Medical Assistance Program on the date drugs are obtained. Individuals with a financial/medical assistance application pending or in a spend-down unmet status may participate in ADAP.
• Eligible for the Medicare Part-D prescription drug plan.
• Receive assistance through Social Security “Extra Help” or Illinois Cares Rx.