Alaska AIDS Drug Assistance Program
Alaska
The AIDS Drug Assistance Program (ADAP) provides FDA approved HIV-related prescription drugs to underinsured and uninsured individuals living with HIV/AIDS.
Contact Information
Division of Public Health
3601 C Street
Suite 540
Anchorage, AK 99524-0249
1-(907) 269-8058 (phone)
1-(907) 561-0453 (fax)
Division of Public Health
3601 C Street
Suite 540
Anchorage, AK 99524-0249
1-(907) 269-8058 (phone)
1-(907) 561-0453 (fax)
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:
ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. - income must be at or below 300% of Federal Poverty Level - non-income assets must fall within the level allowed for Medicaid eligibility - must have established residency in Alaska for at least 30 days - must have a willingness to sign an Intent to Stay letter - must be the last resort payer (no other public assistance, Medicaid, VA benefits, or private insurance) - must be HIV+ - must have a licensed practitioner's prescription - must have been prescibed a medication on the ADAP formulary - must be a client of one of the state funded HIV care consortium lead agencies
ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. - income must be at or below 300% of Federal Poverty Level - non-income assets must fall within the level allowed for Medicaid eligibility - must have established residency in Alaska for at least 30 days - must have a willingness to sign an Intent to Stay letter - must be the last resort payer (no other public assistance, Medicaid, VA benefits, or private insurance) - must be HIV+ - must have a licensed practitioner's prescription - must have been prescibed a medication on the ADAP formulary - must be a client of one of the state funded HIV care consortium lead agencies
Other Information:
An individual may self-refer to the ADAP (and become a client) at the Four A's or be referred to the ADAP by another agency. ADAP eligibility must be determined by a representative of the contract administrative agency (the Four A's). To be considered, each applicant must complete: An "ADAP Intake" form A Four A's (as administrative entity) "Release of Information" form Income verification for 3 recent months or the current tax return All applications are reviewed and eligibility is determined by the Four A's ADAP administrator. AIDS Hotlines: (800)478-3437 En Espanol: (800) 344-7432 Alaskans Living with HIV: 907.463.5688
An individual may self-refer to the ADAP (and become a client) at the Four A's or be referred to the ADAP by another agency. ADAP eligibility must be determined by a representative of the contract administrative agency (the Four A's). To be considered, each applicant must complete: An "ADAP Intake" form A Four A's (as administrative entity) "Release of Information" form Income verification for 3 recent months or the current tax return All applications are reviewed and eligibility is determined by the Four A's ADAP administrator. AIDS Hotlines: (800)478-3437 En Espanol: (800) 344-7432 Alaskans Living with HIV: 907.463.5688
