Maryland AIDS Drug Assistance Program

Maryland

Contact Information
Maryland AIDS Drug Assistance Program
500 N. Calvert Street
Baltimore, MD 21202
1-(800) 638-6252 (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.
Other Information:
Must have proof of current Maryland residency. It takes 5-10 business days to process the application form. Recertification is required every six months. Download an application form from the URL listed below or call Client Services toll-free at 1-800-205-6308. Applications: http://www.dhmh.state.md.us/AIDS/madapp.htm
Product(s) covered by program:
  • Agenerase®
  • Aldara
  • Amoxil®
  • Anadrol-50
  • Atarax
  • Augmentin®
  • Aventyl HCl
  • AZT
  • Bactrim
  • Biaxin® Filmtab
  • Biaxin® Granules
  • Biaxin® XL Filmtab
  • Biomox
  • Celexa
  • Ciloxan
  • Cipro
  • Citrovorum
  • Cleocin
  • Combivir®
  • Compazine
  • Copegus
  • Crixivan®
  • Cytovene
  • d4T
  • Dapsone
  • Daraprim®
  • Daunoxome
  • ddC
  • DDS
  • Depakene
  • Depakote® ER Tablets
  • Depakote® Sprinkle Capsules
  • Depakote® Tablets
  • Desyrel
  • Diflucan®
  • Effexor Tablets
  • Effexor XR Extended-Release Capsules
  • Elavil
  • Emtriva
  • Epivir®
  • EPOGEN®
  • Epzicom®
  • Famvir®
  • Fansidar
  • Flagyl®
  • Fortovase
  • Foscavir
  • Fungizone
  • Fuzeon
  • Gemfibrozil tablet
  • Glucophage
  • Haldol®
  • HIVID
  • Humatin
  • Hydrea
  • Imodium
  • INH
  • Intron A
  • Kaletra®
  • Kaletra® Oral Solution
  • Keflex
  • Keppra
  • Lexapro®
  • Lexiva®
  • Lipitor®
  • Lomotil®
  • Lotrimin
  • Lotrisone Cream
  • Megace
  • Mepron®
  • Metryl
  • Microsulfon
  • Monistat-Derm
  • Myambutol
  • Mycelex®
  • Mycobutin®
  • Mycostatin
  • NebuPent
  • Neupogen
  • Neurontin®
  • Nizoral®
  • Norvir® Oral Solution
  • Norvir® Soft Gelatin Capsules
  • Nydrazid
  • Oxandrin
  • Pamelor
  • Paxil®
  • Peg Intron
  • Pegasys
  • Pentam
  • Polytrim
  • Pravachol®
  • Primaquine Phosphate
  • PROCRIT
  • Prolixin elixir
  • Prolixin oral concentrate
  • Prolixin tablet
  • Proloprim
  • Protostat
  • Proventil Aerosol Inhaler
  • Proventil HFA Inhaler
  • Proventil Inhalation Solution
  • Prozac®
  • Rebetol
  • Remeron SolTab
  • Rescriptor®
  • Retrovir®
  • Reyataz
  • Rifampin
  • Rifater
  • Rimactane
  • Risperdal® Tablets and Oral Solution
  • Roferon-A
  • Sandostatin®
  • Septra
  • Sporanox®
  • Sustiva
  • Thalomid
  • Timox
  • TriCor® Tablets
  • Trilafon
  • Trimpex
  • Trizivir®
  • Truvada
  • Valcyte
  • Valtrex®
  • Videx
  • Viracept®
  • Viramune
  • Viread
  • Vistide
  • Vitravene
  • Wellbutrin®
  • Wellcovorin
  • Wymox
  • Zerit®
  • Ziagen®
  • Zithromax®
  • Zoloft®
  • Zovirax®
  • Zyban®
  • Zyprexa®