Wyoming AIDS Drug Assistance Program (ADAP)


he Wyoming Department of Health's HIV/AIDS Treatment and ADAP Program provides persons living with HIV/AIDS access to comprehensive health care and other supportive services. These programs serve as the payer of last resort for persons who are uninsured, under-insured, or are otherwise unable to access medical treatment. Funding for these programs is provided, in part, by grants from the United States Department of Health and Human Services, Health Resources Services Administration, and the United States Department of Housing and Urban Development.
Contact Information
Wyoming Department of Health
6101 Yellowstone Road
Suite 510
Cheyenne, WY 82002
1-(800) 438-1282 (phone)
1-(307) 777-8547 (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:
    In order to be eligible for assistance, an individual must meet all three of the following requirements: 1. Must be HIV-positive or have a diagnosis of AIDS. A health care provider must verify this by completing the Provider's Medical Certification Form, which is available on our Forms and Downloads page. 2. Must be a resident of, and have a permanent address in, the state of Wyoming. A copy of a valid Wyoming drivers license or state-issued ID card must be submitted along with the Application for Assistance. There are no other acceptable forms of identification. Persons needing to obtain a drivers license or state ID card can obtain more information from the WYDOT Driver Services website. 3. Must have total annual household income at or below the current income guideline, based upon county of residence.
    Other Information:
    The current Application for Assistance form is available from any county public health office, or you may print it directly from our Forms and Downloads page at http://wdh.state.wy.us/phsd/aids/forms.html. If you or someone you know is living with HIV/AIDS, would like to enroll in these programs, or simply need more information, please feel free to contact any public health nursing office in Wyoming. You may also contact the Programs directly by telephone at (307) 777-5856, toll free at (800) 438-1282, or by email at debi.nelson@health.wyo.gov.
    Product(s) covered by program:
    • 3TC
    • Agenerase®
    • Aldara
    • Ambien®
    • Atarax
    • AZT
    • Bactrim
    • Biaxin® Filmtab
    • Biaxin® Granules
    • Biaxin® XL Filmtab
    • Biaxin® XL Pac
    • Combivir®
    • Compazine
    • Crixivan®
    • Cytovene
    • d4T
    • Daraprim®
    • ddC
    • ddI
    • Diflucan®
    • Emtriva®
    • Epivir®
    • Famvir®
    • Fansidar
    • Fortovase
    • Foscavir
    • HIVID
    • Hydrea
    • Imodium
    • Influenza
    • INH
    • Invirase
    • Kaletra®
    • Kaletra® Oral Solution
    • Lanizid
    • Lescol®
    • Lexiva®
    • Lopid®
    • Mevacor Tablets
    • Microsulfon
    • Niaspan 1000mg
    • Niaspan 500 mg
    • Niaspan 750mg
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Nydrazid
    • Percocet
    • Phenergan Suppositories
    • Phenergan Tablets
    • Rescriptor®
    • Retrovir®
    • Reyataz
    • RIF
    • Rifadin
    • Rifampicin
    • Rimactane
    • Septra
    • Sporanox®
    • Sustiva
    • Terbrazid
    • Trizivir®
    • Tylenol 3
    • Tylenol 4
    • Valium
    • Vicodin
    • Videx
    • Videx EC
    • Viracept®
    • Viramune
    • Viread
    • Vistaril®
    • Vistide
    • Wellcovorin
    • Xanax
    • Zerit®
    • Ziagen®
    • Zithromax®
    • Zoloft®
    • Zovirax®