Puerto Rico AIDS Drug Assistance Program

Puerto Rico

Contact Information
Puerto Rico Department of Health, AIDS and Communicable Diseases (OCASET)
G.P.O. Box 70183
San Juan, PR 00936-8523
1-(800) 981-5721 (phone)
1-800-981-5721 (vanity_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.
  • Click here to visit the program's web site.
    • Eligibility:
    ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. - must be HIV+ with a CD4 level below 350 or a viral load greater than 10,000 - must be certified as Medically indigent by the Medicaid program or limited/no coverage by a drug prescription plan, as documented by the state, their health insurance plan, Consortia or Community-Based Organization
    Product(s) covered by program:
    • 3TC
    • Agenerase®
    • Alba-Lybe
    • Albafort
    • Albatussin SR, NN
    • Aldara
    • Amikin
    • Ansaid®
    • Augmentin®
    • Avosulfon®
    • AZT
    • Benadryl®
    • Biaxin® Filmtab
    • Biaxin® Granules
    • Biaxin® XL Filmtab
    • Biaxin® XL Pac
    • Bicillin LA
    • Brondelate
    • Capastat
    • Ciloxan
    • Cipro
    • Cipro I.V.
    • Cipro® Oral Suspension
    • Citrovorum
    • Claritin
    • Cleocin
    • Cleocin Pediatric Oral Susp®
    • Cleocin Phosphate
    • Cleocin T®
    • Cleocin Vaginal Cream/Ovules®
    • Combivir®
    • Crixivan®
    • Cytovene
    • d4T
    • Dapsone
    • Daraprim®
    • ddC
    • ddI
    • DDS
    • Diflucan®
    • Diflucan® Suspension
    • Diprolene AF Cream
    • Diprolene lotion
    • Diprolene ointment
    • Duricef®
    • Elavil
    • Elocon cream
    • Elocon ointment
    • Emla
    • Emla® Anesthetic Disc
    • Emla® Cream
    • Emtriva
    • Epivir®
    • Epivir-HBV®
    • Famvir®
    • Flagyl IV
    • Flagyl IV RTU
    • Flagyl®
    • floinic acid
    • Floxin Otic
    • Floxin®
    • Folic Acid tablet
    • Fortovase
    • Foscavir
    • Fungizone
    • Fuzeon
    • Gamimune N
    • Gammagard S/D
    • Gyne Sulf
    • Gyne-Lotrimin
    • HIVID
    • Imodium
    • INH
    • Kaletra®
    • Kaletra® Oral Solution
    • Kantrex
    • Kenalog aerosol topical
    • Kenalog orabase paste
    • Kenalog vial
    • Lamprene
    • Lotrimin
    • Lotrisone Cream
    • Lotrisone lotion
    • Megace
    • Mepron®
    • MetroGel- Vaginal
    • Microsulfon
    • Myambutol
    • Mycelex®
    • Mycelex® Troche
    • Mycelex-G
    • Mycobutin®
    • Mycostatin
    • NebuPent
    • NebuPent Inhalation Solution
    • Neosporin GU
    • Neosporin Opthalmic
    • Nervidox
    • Neupogen
    • Nizoral®
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Ocuflox
    • Paser
    • PCE Dispertab Tablets
    • Peg Intron
    • Pentam
    • Pentam 300
    • Piridoxina
    • podophyllin
    • Prevacid®
    • Prevacid® NapraPAC™
    • Prevacid® SoluTab™ Delayed-Release Orally Disintegrating Tablets
    • PROCRIT
    • Proventil Aerosol Inhaler
    • Proventil HFA Inhaler
    • Proventil Inhalation Solution
    • Prozac Weekly®
    • Prozac®
    • PZA
    • Rebetol
    • Rescriptor®
    • Retrovir®
    • Reyataz
    • Rifadin
    • Rifampin
    • Rocephin
    • Septra
    • Sermycin
    • SMZ/TMP
    • Spectazole®
    • Spectazole® Cream
    • Sporanox®
    • Sporanox® Oral Solution
    • Sulcrafate
    • Sulfadiazine Tablets
    • Sultrin Triple Sulfa
    • Sustiva
    • Synalar
    • Terazol®
    • Terazol® 3
    • Terazol® 7
    • Tia-Doce
    • Trecator-SC Tablets
    • Trimox
    • Trimox Chewable
    • Trizivir®
    • Trobicin
    • Trysul
    • Tubersol
    • Tylenol®
    • Unicap
    • V.V.S.
    • Valcyte
    • Valtrex®
    • Vibramycin®
    • Videx
    • Videx EC
    • Videx Pediatrics
    • Viracept®
    • Viramune
    • Viread
    • Vistaril®
    • Wellcovorin
    • Xylocaine
    • Zantac®
    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zithromax® Suspension
    • Zithromax® Tri-Pak
    • Zithromax® Z-Pak
    • Zoloft®
    • Zostrix
    • Zovirax®
    • Zyrtec®