Are you uninsured? If you do have health coverage, are your prescription co-pays or other co-insurance costs prohibitively expensive? Or does your health plan come with high medication deductibles that you can’t afford? Help may be available from the following:

Cost-sharing Assistant Programs (CAPs)

Patient Assistance Programs (PAPs)

AIDS Drug Assistance Program (ADAP)

Medicaid

Different assistance programs have different eligibility criteria based on the federal poverty level (FPL). Eligibility for this year is based on last year’s income. The figure is adjusted based on family or household size. A complete table is available here. Unless otherwise stated, companies ask for verification of income, usually in the form of a federal income tax return. Companies also generally consider household income, meaning that a married couple that files joint taxes will be judged on their combined income. People who file individual income tax returns will only have their individual income considered. In many cases, if you are told you are ineligible for assistance, you can appeal to have the decision reversed.

COST-SHARING ASSISTANCE PROGRAMS (CAPs)

These programs offer cost-sharing assistance (including deductibles, co-payments and co-insurance costs) to people with private health insurance to obtain HIV drugs at the pharmacy.


AbbVie (formerly Abbott)
Drugs covered: Kaletra, Norvir
Contact Information: 866-KALETRA (866-525-3872), or go to the product websites (e.g. www.kaletra.com)
Program Details: The program covers the first $400 per month with a $4,800 per year maximum for Kaletra, and up to $100 per month with a $1,200 per maximum for Norvir. Must reapply each year.

Genentech
HIV Drugs covered: Fuzeon 
Contact Information: 877-4-FUZEON (877-438-9366), or go to the Fuzeon website.
Program Details: The Genentech Access to Care Foundation (GATCF) program can help connect underinsured patients with financial assistance foundations. To qualify for support, patients must meet specific criteria.

Gilead Sciences
Drugs covered: Atripla, Biktarvy, Complera, Descovy, Emtriva, Genvoya, Odefsey, Stribild, Truvada, Tybost, Viread
Contact Information: 877-505-6986, or go to product websites (e.g. www.truvada.com)
Program Details: The program covers the first $7,200 per year of co-payments for Biktarvy and Genvoya; the first $6,000 per year of co-payments for Atripla, Complera, Odefsey and Stribild; the first $4,800 per year of co-payments for Descovy and Truvada; the first $300 per month/$3,600 per year of co-payments for Emtriva and Viread; and the first $50 per month/$600 per year of co-payments for Tybost. The program automatically renews annually for enrolled patients.

Janssen Therapeutics
Drugs covered: EdurantIntelence, Prezcobix, Prezista, Symtuza
Contact Information: 877-227-3728 or www.janssencarepath.com/.
Program Details: The program covers the first $7,500 per year of co-payments, deductibles and co-insurance for Edurant, Intelence, Prezcobix and Prezista. The program covers the first $12,500 per year for Symtuza. Must reapply for the program each year.

Merck & Co.
Drugs covered: Delstrigo, Isentress, Isentress HD, Pifeltro
Contact Information: 800-727-5400 or https://www.merckhelps.com/.
Program Details: The program covers out-of-pocket costs up to a maximum total program savings of $6,800. Coupon may be redeemed once every 21 days before the expiration date printed on the coupon, on each qualifying prescription up to 180 tablets each. Must reapply after the coupon expires.

ViiV Healthcare
Drugs covered: DovatoJuluca, Lexiva, RescriptorRetrovirRukobia, SelzentryTivicay, Trizivir, Triumeq, Viracept, and Ziagen
Contact Information: 844-588-3288 or visit www.viivconnect.com.
Program Details: Rukobia and Triumeq have a $7,500 per year/per individual maximum. Dovato and Juluca have a $6,250 per year/per individual maximum. Tivicay has a $5,000 per year/per individual maximumLexiva, Rescriptor, Selzentry, Retrovir, Ziagen, Trizivir and Viracept have a $4,800 per year/per individual maximum.

PATIENT ASSISTANT PROGRAMS (PAPs)

Patient Assistance Programs (PAPs) offer free or low-cost HIV medications to people who do not qualify for any other insurance or assistance programs such as Medicaid, Medicare, or AIDS Drug Assistance Programs (ADAPs).

In 2012, the Department of Health and Human Services (DHHS), along with several pharmaceutical companies, the National Alliance of State and Territorial AIDS Directors (NASTAD), and community stakeholders developed a common patient assistance program application that can be used by both providers and patients to help simplify this process. Click here for the form and click here for the application companion document. 


Pharmaceutical Company: AbbVie
Drugs CoveredKaletra, Norvir
Contact Information800.222.6885 or abbvie.com/patients/patient-support/patient-assistance/eligibility-criteria.html
Pharmaceutical Company: Boehringer Ingelheim
Drugs CoveredAptivus, Viramune XR
Contact Information800-556-8317 or boehringer-ingelheim.com/us/our-responsibility/patient-assistance-program
Pharmaceutical Company: Gilead Sciences
Drugs CoveredBiktarvy, Complera, Descovy, Emtriva, Genvoya, Odefsey, Stribild, Truvada, Tybost
Contact Information800-226-2056 or gileadadvancingaccess.com/financial-support/uninsured 
Pharmaceutical Company: Janssen Therapeutics / Johnson & Johnson
Drugs CoveredEdurant, Intelence, Prezcobix, Prezista, Symtuza
Contact Information800-652-6227 or jjpaf.org/eligibility/requirements.html
Pharmaceutical Company: Merck & Co.
Drugs CoveredDelstrigo, Isentress, Isentress HD, Pifeltro
Contact Information800-727-5400 or www.merckhelps.com/
Pharmaceutical Company: ViiV Healthcare
Drugs CoveredApretude, CabenuvaDovatoEpivir, Juluca, Lexiva, Retrovir, RukobiaSelzentry, Tivicay, Triumeq, Trizivir, Viracept and Ziagen
Contact Information844-588-3288 or www.viivconnect.com

AIDS DRUG ASSISTANCE PROGRAMS (ADAP)

The Ryan White CARE Act is the largest federally funded program for people with HIV. It provides care and support services to people who don’t have insurance or don’t have enough coverage through their other plans. Ryan White also provides funding for ADAP. Find  info for the ADAP program in your state below or click here for additional ADAP resources.


STATE: Alabama
WEBSITEalabamapublichealth.gov/hiv/adap.html
PHONE866.574.9964
STATE: Alaska
WEBSITEalaskanaids.org/index.php/client-services/adap
PHONE907.263.2050
STATE: Arizona
WEBSITEazdhs.gov/preparedness/epidemiology-disease-control/disease-integration-services/index.php#aids-drug-assistance-program-home
PHONE602.364.3610 or 800.334.1540
STATE: Arkansas
WEBSITEhealthy.arkansas.gov/programs-services/topics/ryan-white-program
PHONE501.661.2408
STATE: California
WEBSITEcdph.ca.gov/Programs/CID/DOA/Pages/OAadap.aspx
PHONE916.558.1784
STATE: Colorado
WEBSITEcdphe.colorado.gov/state-drug-assistance-program
PHONE303.692.2000
STATE: Connecticut
WEBSITEctdph.magellanrx.com
PHONE860.424.3310
STATE: D.C. (Washington)
WEBSITEdchealth.dc.gov/DC-ADAP
PHONE202.442.5955
STATE: Delaware
WEBSITEramsellcorp.com/medical_professionals/de.aspx
PHONE302.744.1050
STATE: Florida
WEBSITEfloridahealth.gov/diseases-and-conditions/aids/adap/index.html
PHONE800.352.2437
STATE: Georgia
WEBSITEdph.georgia.gov/adap-program
PHONE404.656.9805
STATE: Hawaii
WEBSITEhealth.hawaii.gov/harmreduction/about-us/hiv-programs/hiv-medical-management-services/
PHONE808.733.9360
STATE: Idaho
WEBSITEhealthandwelfare.idaho.gov/Health/FamilyPlanningSTDHIV/HIVCareandTreatment/tabid/391/Default.aspx
PHONE208.334.5612
STATE: Illinois
WEBSITEdph.illinois.gov/topics-services/diseases-and-conditions/hiv-aids/ryan-white-care-and-hopwa-services
PHONE800.825.3518
STATE: Indiana
WEBSITEin.gov/isdh/17740.htm
PHONE866.588.4948
STATE: Iowa
WEBSITEidph.iowa.gov/hivstdhep/hiv/support
PHONE515.380.6942
STATE: Kansas
WEBSITEkdhe.ks.gov/355/Ryan-White-Part-B-Program
PHONE785.296.6174
STATE: Kentucky
WEBSITEchfs.ky.gov/agencies/dph/dehp/hab/Pages/services.aspx
PHONE502.564.6539
STATE: Louisiana
WEBSITEnew.dhh.louisiana.gov/index.cfm/page/1118
PHONE504.568.7474
STATE: Maine
WEBSITEmaine.gov/dhhs/mecdc/infectious-disease/hiv-std/contacts/adap.shtml
PHONE207.287.3747
STATE: Maryland
WEBSITEhealth.maryland.gov/phpa/OIDPCS/Pages/MADAP.aspx
PHONE410.767.6535 or 800.205.6308
STATE: Massachusetts
WEBSITEcrine.org/hdap/
PHONE617.502.1700
STATE: Michigan
WEBSITEmichigan.gov/dap
PHONE888.826.6565
STATE: Minnesota
WEBSITEmn.gov/dhs/people-we-serve/adults/health-care/hiv-aids/programs-services/medications.jsp
PHONE800.657.3761 or 651.431.2414
STATE: Mississippi
WEBSITEmsdh.ms.gov/msdhsite/_static/14,13047,150.html
PHONE888.343.7373 or 601.362.4879
STATE: Missouri
WEBSITEon.mo.gov/2hqrKyE
PHONE573.751.6439
STATE: Montana
WEBSITEdphhs.mt.gov/publichealth/hivstd/treatment/mtryanwhiteprog
PHONE406.444.3565
STATE: Nebraska
WEBSITEdhhs.ne.gov/Pages/HIV-Care.aspx
PHONE402.471.2101
STATE: Nevada
WEBSITEendhivnevada.org/end-hiv-nevada-program/nevadas-aids-drug-assistance-program-adap/
PHONE775.684.4025
STATE: New Hampshire
WEBSITEdhhs.nh.gov/programs-services/disease-prevention/infectious-disease-control/nh-ryan-white-care-program/nh-adap
PHONE603.271.4502 or 800.852.3345 
STATE: New Jersey
WEBSITEstate.nj.us/health/hivstdtb/hiv-aids/medications.shtml
PHONE877.613.4533
STATE: New Mexico
WEBSITEnmhealth.org/about/phd/idb/hats/
PHONE505.476.3628
STATE: New York
WEBSITEhealth.ny.gov/diseases/aids/resources/adap/
PHONE800.542.2437
STATE: North Carolina
WEBSITEepi.publichealth.nc.gov/cd/hiv/hmap.html
PHONE

877.466.2232 or 919.733.9161

STATE: North Dakota
WEBSITEndhealth.gov/hiv/Resources/
PHONE701.328.2378 or 800.472.2180
STATE: Ohio
WEBSITEodh.ohio.gov/know-our-programs/Ryan-White-Part-B-HIV-Client-Services/AIDS-Drug-Assistance-Program/
PHONE800.777.4775
STATE: Oklahoma
WEBSITEoklahoma.gov/health/services/personal-health/sexual-health-and-harm-reduction-service/community-resources---partners.html
PHONE405.426.8400
STATE: Oregon
WEBSITEoregon.gov/oha/ph/DiseasesConditions/HIVSTDViralHepatitis/HIVCareTreatment/CAREAssist/Pages/index.aspx
PHONE971.673.0144
STATE: Pennsylvania
WEBSITEhealth.pa.gov/topics/programs/HIV/Pages/Special-Pharmaceutical-Benefits.aspx
PHONE800.922.9384
STATE: Rhode Island
WEBSITEeohhs.ri.gov/Consumer/Adults/RyanWhiteHIVAIDS.aspx
PHONE401.462.3295
STATE: South Carolina
WEBSITEscdhec.gov/Health/DiseasesandConditions/InfectiousDiseases/HIVandSTDs/AIDSDrugAssistancePlan/
PHONE800.856.9954
STATE: South Dakota
WEBSITEdoh.sd.gov/diseases/infectious/ryanwhite/
PHONE800.592.1861 or 605.773.3737
STATE: Tennessee
WEBSITEtn.gov/health/health-program-areas/std/std/ryanwhite.html
PHONE800.525.2437 or 615.741.7500
STATE: Texas
WEBSITEdshs.state.tx.us/hivstd/meds/default.shtm
PHONE800.255.1090 or 737.255.4300
STATE: Utah
WEBSITEptc.health.utah.gov/treatment/ryan-white/
PHONE801.538.6191
STATE: Vermont
WEBSITEhttps://www.healthvermont.gov/immunizations-infectious-disease/hiv/care
PHONE802.951.4005
STATE: Virginia
WEBSITEhttps://www.vdh.virginia.gov/disease-prevention/vamap/
PHONE855.362.0658
STATE: Washington
WEBSITEdoh.wa.gov/YouandYourFamily/IllnessandDisease/HIVAIDS/HIVCareClientServices/ADAPandEIP
PHONE877.376.9316 or 360.236.3426
STATE: West Virginia
WEBSITEoeps.wv.gov/rwp/pages/default.aspx
PHONE304.232.6822
STATE: Wisconsin
WEBSITEdhs.wisconsin.gov/aids-hiv/resources/overviews/AIDS_HIV_drug_reim.htm
PHONE800.991.5532 or 608.267.6875
STATE: Wyoming
WEBSITEhealth.wyo.gov/publichealth/communicable-disease-unit/hiv/resources-for-patients/
PHONE307.777.7529

MEDICAID

Medicaid is a critical source of coverage of people living with HIV. Currently you can qualify for Medicaid if you have a low income and are part of a “categorically eligible” group (children, parents with dependent children, pregnant women, and people with disabilities). Each state establishes and administers their own Medicaid program but they are all required to cover certain mandatory benefits. Under the ACA, states have the option of expanding Medicaid eligibility to include people below certain income levels. You can apply for and enroll in Medicaid at any time. Here’s info on how to find out more about Medicaid options in your state:


STATE: Alabama
WEBSITEmedicaid.alabama.gov
PHONE334.242.5000
STATE: Alaska
WEBSITEdhss.alaska.gov/health/dhcs/Pages/medicaid_medicare/default.aspx
PHONE800.478.7778
STATE: Arizona
WEBSITEazahcccs.gov
PHONE602.417.4000
STATE: Arkansas
WEBSITEaccess.arkansas.gov/Learn/Home
PHONE855.372.1084
STATE: California
WEBSITEdhcs.ca.gov/services/medi-cal/Pages/default.aspx
PHONE916.552.9200
STATE: Colorado
WEBSITEhealthfirstcolorado.com
PHONE800.221.3943
STATE: Connecticut
WEBSITEct.gov/hh/site/default.asp
PHONE877.284.8759
STATE: D.C. (Washington)
WEBSITEdc-medicaid.com/dcwebportal/home
PHONE202.727.5355
STATE: Delaware
WEBSITEdhss.delaware.gov/dss/medicaid.html
PHONE800.996-9969
STATE: Florida
WEBSITEbenefits.gov/benefit/1625
PHONE888.762.2237
STATE: Georgia
WEBSITEmedicaid.georgia.gov
PHONE404.651.9982
STATE: Hawaii
WEBSITEmedquest.hawaii.gov
PHONE808.524.3370
STATE: Idaho
WEBSITEhealthandwelfare.idaho.gov/Medical/Medicaid/tabid/123/Default.aspx
PHONE877.456.1233
STATE: Illinois
WEBSITEbenefits.gov/benefit/1628
PHONE800.843.6154
STATE: Indiana
WEBSITEin.gov/medicaid/members/apply-for-medicaid/
PHONE800.457.4584
STATE: Iowa
WEBSITEdhs.iowa.gov/ime/members/who-receives-medicaid
PHONE800.338.8366
STATE: Kansas
WEBSITEcssp.kees.ks.gov/apspssp/
PHONE800.792.4884
STATE: Kentucky
WEBSITEchfs.ky.gov/agencies/dms/member/Pages/Apply.aspx
PHONE855.306.8959
STATE: Louisiana
WEBSITEdhh.louisiana.gov/index.cfm/subhome/1/n/331
PHONE888.342.6207
STATE: Maine
WEBSITEmaine.gov/dhhs/oms/
PHONE855.797.4357
STATE: Maryland
WEBSITEhealth.maryland.gov/mmcp/pages/home.aspx
PHONE
410.767.1594
STATE: Massachusetts
WEBSITEmass.gov/eohhs/gov/departments/masshealth/
PHONE800.841.2900
STATE: Michigan
WEBSITEmichigan.gov/mdhhs/assistance-programs/medicaid/portalhome/beneficiaries
PHONE800.975.7630
STATE: Minnesota
WEBSITEbenefits.gov/benefit/1286
PHONE855.366.5411
STATE: Mississippi
WEBSITEmedicaid.ms.gov/
PHONE800.421.2408
STATE: Missouri
WEBSITEmydss.mo.gov/healthcare/apply
PHONE855.373.9994
STATE: Montana
WEBSITEdphhs.mt.gov/MontanaHealthcarePrograms/MemberServices
PHONE888.706.1535.
STATE: Nebraska
WEBSITEdhhs.ne.gov/Pages/Medicaid-Eligibility.aspx
PHONE

855.632.7633

Lincoln:

402.473.7000

Omaha:

402.595.1178

STATE: Nevada
WEBSITEdhhs.nv.gov/find_assistance/medical_assistance/
PHONE800.992.0900
STATE: New Hampshire
WEBSITEdhhs.nh.gov/programs-services/medicaid
PHONE844.275.3447
STATE: New Jersey
WEBSITEstate.nj.us/humanservices/dmahs/clients/medicaid/
PHONE800.701.0710
STATE: New Mexico
WEBSITEnmmedicaid.portal.conduent.com/static/index.htm
PHONE800.283.4465
STATE: New York
WEBSITEhealth.ny.gov/health_care/medicaid/
PHONE800.541.2831
STATE: North Carolina
WEBSITEdma.ncdhhs.gov/medicaid
PHONE888.245.0179
STATE: North Dakota
WEBSITEnd.gov/dhs/services/medicalserv/medicaid/
PHONE701.328.7068
STATE: Ohio
WEBSITEmedicaid.ohio.gov/families-and-individuals/coverage/coverage
PHONE800.324.8680
STATE: Oklahoma
WEBSITEokhca.org
PHONE800.987.7767
STATE: Oregon
WEBSITEhttps://www.oregon.gov/oha/HSD/OHP/Pages/Apply.aspx
PHONE800.699.9075
STATE: Pennsylvania
WEBSITEdhs.pa.gov/Services/Assistance/Pages/Medical-Assistance.aspx
PHONE866.550.4355
STATE: Rhode Island
WEBSITEdhs.ri.gov/programs-and-services/medicaid-medicare-programs
PHONE855.697.4347
STATE: South Carolina
WEBSITEapply.scdhhs.gov/CitizenPortal/application.do
PHONE888.549.0820
STATE: South Dakota
WEBSITEdss.sd.gov/medicaid/generalinfo/apply.aspx
PHONE877.999.5612
STATE: Tennessee
WEBSITEtenncareconnect.tn.gov
PHONE 855.259.0701
STATE: Texas
WEBSITEhhs.texas.gov/services/health/medicaid-and-chip
PHONE800.252.8263
STATE: Utah
WEBSITEhealth.utah.gov/medicaid/
PHONE

866.435.7414

STATE: Vermont
WEBSITEdvha.vermont.gov/members/medicaid
PHONE800.250.8427
STATE: Virginia
WEBSITEdmas.virginia.gov/for-applicants/applying-for-medicaid/
PHONE

855.242.8282

STATE: Washington
WEBSITEdshs.wa.gov/altsa/home-and-community-services/how-apply-medicaid
PHONE855.923.4633
STATE: West Virginia
WEBSITEwvpath.wv.gov
PHONE800.318.2596
STATE: Wisconsin
WEBSITEdhs.wisconsin.gov/medicaid/index.htm
PHONE800.362.3002
STATE: Wyoming
WEBSITEhealth.wyo.gov/healthcarefin/medicaid/
PHONE307.777.7531

Looking for drug assistance programs for viral hepatitis? Please visit hepmag.com.

The CAP and PAP information on this page is based on a document originally produced by the Fair Pricing Coalition, an ad hoc group of activists who advocate with the pharmaceutical industry regarding the price and patient access to HIV and viral hepatitis drugs. For more information, please visit www.fairpricingcoalition.org.

Last Reviewed: February 27, 2023