Vermont AIDS Drug Assistance Program

Vermont

Contact Information
Moretti, HIV/AIDS Insurance Programs Coordinator
P.O. Box 70
108 Cherry Street, Drawer 41 HAST
Burlington, VT 05401-9962
1-(802) 863-7253 (phone)
1-(802) 863-7314 (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.
  • Click here to visit the program's web site.
    • Eligibility:
    ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. - the applicant's net income must be at or below 200% of the current Federal Poverty Level - there are sliding scale co-payments for income over 200% - must be HIV+
    Other Information:
    Call Moretti at 802-863-7253 to enroll.
    Product(s) covered by program:
    • Adriamycin
    • Agenerase®
    • AZT
    • Bactrim
    • Biaxin® Filmtab
    • Biaxin® Granules
    • Biaxin® XL Filmtab
    • Celexa
    • Cipro
    • Cleocin
    • Combivir®
    • Crixivan®
    • d4T
    • Daraprim®
    • ddC
    • ddI
    • DDS
    • Desyrel
    • Diflucan®
    • DOXIL
    • Duragesic® CII
    • Effexor Tablets
    • Elavil
    • Emtriva
    • Epivir®
    • Famvir®
    • Fibercon
    • Fortovase
    • Foscavir
    • Fungizone
    • Fuzeon
    • HIVID
    • Hydrea
    • Imodium
    • Invirase
    • Kaletra®
    • Kaletra® Oral Solution
    • Lescol®
    • Lexiva®
    • Lipitor®
    • Lopid®
    • Lotrimin
    • Megace
    • Mepron®
    • Metamucil
    • Mevacor Tablets
    • Microsulfon
    • Motrin®
    • MS Contin
    • Myambutol
    • Mycelex®
    • Mycobutin®
    • Mycostatin
    • NebuPent
    • Neupogen
    • Neurontin®
    • Nizoral®
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Paxil®
    • Pentam
    • Pravachol®
    • Primaquine Phosphate
    • Proloprim
    • Prozac®
    • Rescriptor®
    • Retrovir®
    • Reyataz
    • Septra
    • Serzone
    • Sporanox®
    • Sustiva
    • Trimpex
    • Trizivir®
    • Valcyte
    • Videx
    • Videx EC
    • Viracept®
    • Viramune
    • Viread
    • Vistide
    • Wellbutrin®
    • Wellcovorin
    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zocor Tablets
    • Zoloft®
    • Zovirax®