AIDS Drugs Assistance Program (ADAP)

What is the Health Insurance Assistance Program (HIAP)?

Many of those living with HIV disease are able to continue employment at a business which offers healthcare and medication coverage while they manage their treatment. Others are able to maintain a COBRA policy through a former employer while they are transitioning to a new job or to disability. The HIAP is intended to assist eligible participants to maintain access to these benefits. The insurance coverage must provide “creditable” pharmaceutical coverage, and be cost-neutral to the HIV Medication Assistance Program (HMAP) to provide the same coverage. This program has the additional benefit of providing access to medical treatment for its participants.

How do you qualify for the Insurance Program?

• You must be a Colorado resident
• You must have proof of HIV positive diagnosis from a doctor or testing facility. You may also access the program if a family member that is not HIV positive can acquire insurance from their employer on your behalf.
• You or your family must be at or below 400 percent of the Federal Poverty Level, (see below).
• You must be eligible for medical insurance or a COBRA policy through which you would be able to access medications in an affordable manner.
• If you are eligible for Medicaid, you must access your medications through that system. The ADAP system must be the payer of last resort.
• If you are eligible for Medicare, you must receive assistance through the Medicare Part D assistance program (Bridging the Gap, Colorado State Pharmaceutical Assistance Program). See the Medicare Part D tab to the left.

HIV Medication Assistance Program (HMAP)

Eligible enrollees who have no access to any form of other insurance will be placed on the HIV Medication Assistance Program (or HMAP). They will receive the HMAP formulary medications free of charge through a very limited network of pharmacies. If you receive your HIV Medical Care at Denver Health, University of Colorado Hospital, or Children’s Hospital, you may access the pharmacy at the Infectious Disease Pharmacy of these facilities. If not, you would access your medications through the Walgreens Pharmacy at Rose Hospital, often via mail order.

Supplemental Wrap-Around Program (SWAP)

SWAP is for people eligible for Medicaid. Enrollees have co-pays of $1 to $3 for each prescription they received through Medicaid. Colorado ADAP developed SWAP to help with these costs of medication co-pays for the HIV drugs and some other drugs that you take. In order to sign up for SWAP, you will simply need to fill out the very short application and return it to the ADAP Office. Once we have gotten your form, your pharmacy will be able to bill ADAP for the co-pays for any medication that is on the ADAP formulary.

Once enrolled, you will be immediately able to have these charges billed to ADAP at the primary ADAP pharmacies at Denver Health, University of Colorado, and the Walgreens Pharmacies at Rose and Children’s Hospital. These pharmacies can look up your SWAP ID number in the Ramsell database and help you right away. Once you receive a new card from Ramsell Public Health, you will be able to use your new card at any King Soopers, City Market, Walgreens, Avella pharmacy, Kaiser (only if you are a Kaiser patient), and the Apothecary in Boulder among others. Call 1-888-311-7632 to find out if a pharmacy is in our network or to locate one close to you. These pharmacists will not be able to look up your information without the Ramsell card.