Illinois AIDS Drug Assistance Program

Illinois

Contact Information
Illinois Department of Public Health
ADAP/CHIC Administrator
525 West Jefferson Street, 1st Floor
Springfield, IL 62761-0001
1-(800) 825-3518 (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.

    - patient must be HIV+
    - gross income must be at or below 400% of the federal poverty level
    - health insurance provides less than 80% of cost of prescription medication
    - must not be eligible for Medicaid through the Department of Public Aid
    - must not be eligible for payment of prescription drugs from any other governmental entity
    - the patient must be a legal resident of Illinois
    - the patient must be a U.S. citizen, U.S. resident, or a qualified alien

    Other Information:
    Nancy K. Abraham, ADAP Coordinator
    Contact Information:
    Tel: (217) 524-5983
    Fax: (217) 785-8013
    e-mail: nabraham@idph.state.il.us

    AIDS Hotline: (800) 243-2437

    Product(s) covered by program:
    • Achromycin V
    • Agenerase®
    • Amoxil®
    • AZT
    • Bactrim
    • Biaxin® Filmtab
    • Biaxin® Granules
    • Biaxin® XL Filmtab
    • C0-Trimoxazole
    • Cipro
    • Cipro HC Otic
    • Cipro I.V.
    • Cipro® Oral Suspension
    • Cleocin T®
    • Combivir®
    • Crixivan®
    • Cytovene
    • d4T
    • Daraprim®
    • ddC
    • ddI
    • DDS
    • Diflucan®
    • Doryx
    • Dycill
    • Dynapen
    • Epivir®
    • Famvir®
    • Floxin®
    • Folic Acid tablet
    • Fortovase
    • Foscavir
    • Fungizone
    • Gantanol
    • HIVID
    • Humatin
    • Hydrea
    • INH
    • Intron A
    • Invirase
    • Kaletra®
    • Kaletra® Oral Solution
    • Keflex
    • Leucovorin
    • Lotrimin
    • Marinol
    • Megace
    • Mepron®
    • Monistat-Derm
    • Myambutol
    • Mycelex®
    • Mycobutin®
    • Mycostatin
    • NebuPent
    • NebuPent Inhalation Solution
    • Nizoral®
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Pathocil
    • Pentam
    • Peridex
    • PerioGard
    • Proloprim
    • Rescriptor®
    • Retrovir®
    • Rifampin
    • Rifater
    • Rimactane
    • Septra
    • Sporanox®
    • Sulfatrim
    • Sumycin
    • Suprax
    • Sustiva
    • Terazol® 3 Vaginal Cream 0.8%
    • Terazol® 3 Vaginal Suppositories
    • Terazol® 7
    • Tetracyn
    • Trimox
    • Trimpex
    • Trizivir®
    • Urobak
    • Vibra-Tabs
    • Vibramycin®
    • Videx
    • Videx EC
    • Viracept®
    • Viramune
    • Viread
    • Vistide
    • Wymox
    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zovirax®