Arizona AIDS Drug Assistance Program
Arizona
The Arizona Department of Health Services (ADHS) is responsible for the administration of ADAP for the state of Arizona. ADAP provides access to medications used to treat HIV and prevent the onset of related opportunistic infections to low-income individuals with HIV disease who have limited or no coverage from private insurance or Medicaid.
Contact Information
Coordinator, Office of HIV/AIDS
Arizona Department of Health Services
150 North 18th Avenue, suite 110
Phoenix, AZ 85007-3233
1-(800) 334-1540 (phone)
Coordinator, Office of HIV/AIDS
Arizona Department of Health Services
150 North 18th Avenue, suite 110
Phoenix, AZ 85007-3233
1-(800) 334-1540 (phone)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Eligibility:
You must be HIV-infected and a resident of Arizona. Annual income is set at 300% of federal poverty level. For example, you cannot have an income of more than $32,490 for a family unit of one. Assistance in determining qualifying income limits based upon monthly income. You cannot be eligible for AHCCCS (Arizona's version of Medicaid) nor have any other benefits that could pay for the medications. To ensure that Ryan White Part B is the payer of last resort for ADAP, all individuals applying for ADAP are screened for AHCCCS eligibility, which means all applicants must have AHCCCS denial letters. ADAP clients will be required to provide documentation of Arizona residency.
You must be HIV-infected and a resident of Arizona. Annual income is set at 300% of federal poverty level. For example, you cannot have an income of more than $32,490 for a family unit of one. Assistance in determining qualifying income limits based upon monthly income. You cannot be eligible for AHCCCS (Arizona's version of Medicaid) nor have any other benefits that could pay for the medications. To ensure that Ryan White Part B is the payer of last resort for ADAP, all individuals applying for ADAP are screened for AHCCCS eligibility, which means all applicants must have AHCCCS denial letters. ADAP clients will be required to provide documentation of Arizona residency.
Other Information:
Have Questions Or Want Additional Information? If you have questions or would like additional information about the program, please call (602) 364-3594, (602) 364-3595, (602)364-3610 or toll free at (800) 334-1540 (in-state only) and ask for the ADAP program.
Have Questions Or Want Additional Information? If you have questions or would like additional information about the program, please call (602) 364-3594, (602) 364-3595, (602)364-3610 or toll free at (800) 334-1540 (in-state only) and ask for the ADAP program.
Product(s) covered by program:
- Agenerase®
- AZT
- Bactrim
- Biaxin® Filmtab
- Biaxin® Granules
- Biaxin® XL Filmtab
- Combivir®
- Crixivan®
- d4T
- Dapsone
- Daraprim®
- ddC
- ddI
- DDS
- Diflucan®
- Emtriva
- Epivir®
- Fortovase
- Fuzeon
- HIVID
- Invirase
- Kaletra®
- Kaletra® Oral Solution
- Lexiva®
- Mycobutin®
- NebuPent
- Norvir® Oral Solution
- Norvir® Soft Gelatin Capsules
- Rescriptor®
- Retrovir®
- Reyataz
- Septra
- Sustiva
- Trizivir®
- Videx
- Videx EC
- Viracept®
- Viramune
- Viread
- Zerit®
- Ziagen®
- Zithromax®
- Zovirax®
