POZitive Attitudes

There are 3 types of assistance programs that help with the cost of medications for people with HIV; AIDS Drug Assistance Program-ADAP; Patient Assistance Programs-PAP, and HIV Medication Co-pay Programs. All three are covered in this page and tailored to Broward County when appropriate.

ADAP is paid through the Broward County Health Department. PAP or Patient Assistant Programs are sponsored by the various drug companies to supply drugs for people with lower incomes. Co-pay Programs help with the insurance co-pays for any income level, but are only available for those with private insurance and cannot help with co-payments for Medicare Part D, Medicaid or any other government program.

ADAP no longer has a waiting list.

Patients are being enrolled into the program (and placed in open status) usually within two to three days of applying.

Since ADAP is now able to enroll patients quickly into the program, once they have completed the eligibility process, please do not refer the applicants to Patient Assistance Programs (PAPs) or have clinicians complete Medical Exception Requests (MERs). If a patient is in immediate need of medications, attempts should be made to access local resources (Part A Programs, Part B Programs, other local resources, etc) for a temporary fill.

We want to be certain patients do not experience any gap in their medications. If your patients are having delays or difficulties getting into ADAP, which will delay them in receiving their medications, please contact the ADAP Team or the Medical Team at the HIV/AIDS and Hepatitis Program so we can assist.

The ADAP Team can be reached by calling 850-245-4335. The Medical Team can be reached by calling Debbie Taylor, RN, at 850-245-4334 ext 4488 and via email atDebbie_Taylor@doh.state.fl.us or by calling Allison Roberts, RN, at 850-245-4334 ext 2536 and via email at Allison_Roberts@doh.state.fl.us.

Please understand email communication sent to our DOH Medical listserv only reaches County Health Department clinicians and limited Ryan White providers, so please share this email with other medical providers in your area.

Regards,
Jeff

Jeffrey A. Beal, M.D., AAHIVS
Medical Director, HIV/AIDS and Hepatitis Program
Florida Department of Health
Bureau of Communicable Diseases
850-519-3734
Fax: 239-332-9656
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Patient Assistance Programs
– www.NeedyMeds.org
– www.rxhope.org 1-877-267-0517
– www.PParx.org 1-877-267-0517
– www.rxassist.org
– www.Togetherrxaccess.com 1-800-444-4106

–www.PatientAssistance.com 1-888-477-2669
– www.rxoutreach.com 1-800-769-3880 (Generics at deep discounts)
– www.xubex.com 1-866-699-8239 (Generics at deep discounts)
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FPL = Federal Poverty Levels  New 2011 Federal Poverty Guidelines are finally available!  Some agencies, including Broward County Health Department are slow to update to new guidelines, but increase should allow your eligiblity if you qualify. Ask them to review the new guidelines if you are turned down.  Please also note the increase if you have been turned down for a Patient Assistance Program or other social service.

The new Federal Poverty Guidelines for 2011 are listed below:

100% <10,890 for Household of 1, <$14,710 for Household of 2.

135% <14,702 for Household of 1, <$19,859 for Household of 2 (this figure is for Full Extra Help from Medicare Part D).

150% <$16,335 for Household of 1, <$22,065 for Household of 2 (this is the cut-off for Medicare part D clients to receive partial Extra Help)  Apply for Extra Help anyway if you are slightly above.  This is also the income limit for Poverello Food bank.

200% <$21,780 for Household of 1, <$29,420 for Household of 2

250% <$27,225 for Household of 1, <$36,775 for Household of 2

300% <$32,670 for Household of 1, <$44130 for Household of 2 (by end of April 2011, this should be the cut off for ADAP and most other Ryan White services-I will post if delayed).

400% <$43,560 for Household of 1, <$58,840 for Household of 2 (This is the current cut-off for ADAP Eligibility. Will be lowered soon).  This is the eligibility level for AICP (AIDS Insurance Continuation Program) and HICP (Health Insurance Continuation Program-Broward County provides if AICP is on Wait List).

500% <$54,450 for Household of 1, <$73,550 for Household of 2 (Some Patient Assistance Programs, especially for expensive HIV and Hepatitis meds, will help at this income level)

Source:  http://www.federalregister.gov/articles/2011/01/20/2011-1237/annual-update-of-the-hhs-poverty-guidelines

Patient assistance programs sometimes look at these as GROSS Income, the amount before any taxes or deductions are subtracted (It can vary from program to program). Unlike ADAP currently, many Patient Assistance Programs also look at your assets such as mutual funds, stocks, bonds, etc…your primary home and car and not included
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Even if you think you are not eligible, please call the program for inquiries and/or apply anyway. Many patients who are turned down initially get the medication through appeal, so get your doctor’s help and do not hesitate to appeal a denial from any Patient Assistance Program.
PAP’s may want tax returns, proof of income and possibly assets when considering application which may be more stringent than ADAP eligiblity.
All Applications are reviewed case by case and subject to change without notice and at any time.***

The most up to date information on Patient Assistance Programs for HIV and Hepatitis drugs can be found at www.fairpricingcoalition.org/projects.  For other drugs, again the contact info is Paula at (954) 467-4700 extension 5669.

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HIV Medication Co-pay Programs(Co-pay Programs are only available for those with private insurance and cannot help with co-payments for Medicare Part D, Medicaid or any other government program). The most up to date information can be found at www.fairpricingcoalition.org/projects.

Abbott: Positive Partnership Plus Card- This includes 12 months of co-pay savings and covers Kaletra plus up to 2 other ARVs, no income or co-pay eligibility criteria. Patients can save up to $50 per month toward their Kaletra co-pay, plus up to $100 of the cost of other HIV medications (up to $50 for each additional ARV with a $100 limit total-must be part of a Kaletra regimen. Patients must get their card from their provider. Call 1-800-556-8317 or visit www.kaletra.com for more info.
A new improved Norvir co-pay card available. Effective February 14, 2011, program will cover first $50 per month for Norvir prescription. Please call 1-800-556-8317.

Boehringer Ingelheim: Viramune Co-Pay Savings Card-card is valid for amount of patient’s out-of-pocket cost up to $50 per month for 12 months. Patients must get card from their healthcare provider. The card is a Mastercard debit card, and must be activated at www.viramune.com or by calling the toll-free number on the card.

Bristol-Myers Squibb: Reyataz and Sustiva Co-Pay Benefit Program-Covers Reyataz and Sustiva up to $200 per month for each drug. Patient can obtain card from their healthcare provider, by calling 1-888-281-8981, or print their card at www.bmshivcopayprogram.com.

BMS and Gilead Sciences: Atripla Co-Pay Assistance Program changed July 1, 2010. Co-pay assistance will now cover co-payments up to $200 per prescription. Requirement that Patient pay the first $50 has been eliminated. If provider does not have the card, call toll free 1-866-784-3431 and one will be mailed. Visit www.atripla.com.

Gilead Sciences: Covers Truvada, Viread and Emtriva. As of July 1, 2010, program has enhanced eligibility and will pay up to $200 per month for each prescription. Please call toll-free 1-888-358-0398 for a card to be mailed to you or ask your health care provider.

Merck & Co: Isentress Patient Savings Coupon Program provides savings up to a maximum of $400 per prescription, per month.. Visit www.Isentress.com or call 1-866-350-9232.

Tibotec: Tibotec Therapeutics Patient Savings Program for Prezista and Intelence. This program has new enhanced eligibility critieria. If patient meets eligibility criteria, patient pays $5 per prescription and Patient Savings Program card covers up to $100 per month per prescription. The new criteria are brand new and generous. Please call 1-866-961-7169 for more details.

ViiV Healthcare: My Support Card covers all GSK and Pfizer HIV medications with no income criteria. Medications covered are Combivir, Epivir, Epzicom, Lexiva, Rescriptor, Retrovir, Selzentry, Trizivir, Viracept and Ziagen. The card is valid for the amount of the patient’s actual out-of-pocket cost up to a maximum of $100 per each prescription. You can get the card from your provider or print the card online at www.mysupportcard.com, or call 1-888-825-5249.