Wisconsin AIDS/HIV Drug Assistance Program (ADAP)

Wisconsin

Contact Information
1 West Wilson Street, Room 318
P.O. Box 2659
Madison, WI 53701-2659
1-(800) 991-5532 (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 live in Wisconsin - must be HIV +, which must be confirmed by a physician - must have no or insufficient third party payment
    Product(s) covered by program:
    • Agenerase®
    • Bactrim
    • Biaxin® Filmtab
    • Cleocin
    • Combivir®
    • Compazine
    • Copegus
    • Crixivan®
    • Cytovene
    • Dapsone
    • Daraprim®
    • Diflucan®
    • Elavil
    • Emtriva
    • Epivir®
    • Famvir®
    • Fortovase
    • Foscavir
    • Fungizone
    • Fuzeon
    • HIVID
    • Hydrea
    • Imodium
    • Intron A
    • Invirase
    • Kaletra®
    • Lexiva®
    • Lipitor®
    • Lomotil®
    • Lonox
    • Lopid®
    • Mepron®
    • Myambutol
    • Mycobutin®
    • NebuPent
    • Neurontin®
    • Niaspan 1000mg
    • Niaspan 500 mg
    • Niaspan 750mg
    • Nizoral®
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Peg Intron
    • Pegasys
    • Pravachol®
    • Rebetol
    • Rebetron
    • Rescriptor®
    • Retrovir®
    • Reyataz
    • Septra
    • Sporanox®
    • Sulfadiazine Tablets
    • Sustiva
    • TriCor® Tablets
    • Trizivir®
    • Valcyte
    • Valtrex®
    • Videx
    • Videx EC
    • Viracept®
    • Viramune
    • Viread
    • Vistide
    • Vitrasert
    • Wellcovorin
    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zovirax®