Connecticut AIDS Drug Assistance Program

Connecticut

Contact Information
Dept of Social Services
Medical Operations Unit #4
55 Farmington Avenue
Hartford, CT 06105-3730.
1-(800) 233-2503 (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. - income must be at or below 400% of the current Federal Poverty Level - must be HIV positive - status must be certified by a physician - there are no limit on assets - must not be a recipient of Medicaid - must apply for Medicaid within two weeks of approval for ADAP
Other Information:
Michael Leary Tel: 860-424-5131 e-mail: michael.leary@ct.gov
Product(s) covered by program:
  • 3TC
  • ACTOS®
  • Agenerase®
  • Anadrol-50
  • Atarax
  • Atromid-S
  • Augmentin®
  • Avandia®
  • Avosulfon®
  • AZT
  • Bactrim
  • Bactroban®
  • Bicillin
  • Buspar
  • Cardizem
  • Carnitor
  • Celebrex®
  • Celexa
  • Cipro
  • Citrovorum
  • Cleocin
  • Cogentin
  • Combivir®
  • Copegus
  • Covera-HS®
  • Crixivan®
  • Cytovene
  • d4T
  • Daraprim®
  • ddC
  • ddI
  • Deca-Durabolin
  • Deltasone
  • Depakote® ER Tablets
  • Depakote® Sprinkle Capsules
  • Diflucan®
  • Digoxin Tablet
  • Duragesic® CII
  • Dynacin
  • Elavil
  • Emtriva
  • Entex PSE
  • Epivir®
  • EPOGEN®
  • Famvir®
  • Fansidar
  • Flagyl®
  • Flovent®
  • Floxin®
  • Fortovase
  • Foscavir
  • Fungizone
  • G-CSF
  • Glucophage
  • HIVID
  • Humatin
  • Hydrochlorothiazide (HCTZ)
  • Imdur tablets
  • Imodium
  • Invirase
  • Isordil
  • Kaletra®
  • Kaletra® Oral Solution
  • Keflex
  • Klonopin
  • Lexiva®
  • Lipitor®
  • Liquid Pred
  • Lomotil®
  • Lonox
  • Lotrimin
  • Macrobid
  • Marinol
  • Megace
  • Mepron®
  • Metocorten
  • MetroCream
  • Microsulfon
  • Motrin®
  • Myambutol
  • Mycelex®
  • Mycobutin®
  • Mycostatin
  • Mykinac
  • Naprosyn
  • Nasonex
  • NebuPent
  • Neupogen
  • Neurontin®
  • Nilstat
  • Nizoral®
  • Normodyne
  • Norvir® Oral Solution
  • Norvir® Soft Gelatin Capsules
  • Nystex
  • O-V Statin
  • Orasone
  • Orudis
  • Oxandrin
  • Panasol
  • Peg Intron
  • Pegasys
  • Pentam
  • Pepcid RPD
  • Pepcid tablets and oral Suspension
  • Peridex
  • Prednicen-M
  • Prevacid®
  • Primaquine Phosphate
  • Prinivil tablets
  • PROCRIT
  • Proloprim
  • Proventil Aerosol Inhaler
  • Proventil HFA Inhaler
  • Proventil Inhalation Solution
  • Prozac®
  • Questran
  • Rebetol
  • Remeron SolTab
  • Retrovir®
  • Reyataz
  • Sporanox®
  • Sterapred
  • Synthroid® Tablets
  • Tegretol®
  • Tenormin® Tablets
  • Tequin®
  • Terazol® 3 Vaginal Cream 0.8%
  • Terazol® 7 Vaginal Cream
  • Toprol® XL
  • Trizivir®
  • Tussi-Organidin S-NR
  • Valcyte
  • Valtrex®
  • Vasotec
  • Veetids
  • Videx
  • Viracept®
  • Viread
  • Vistide
  • Wellbutrin SR®
  • Wellcovorin
  • Xanax
  • Zerit®
  • Zestril® Tablets
  • Ziagen®
  • Zovirax®
  • Zyprexa®
  • Zyrtec®