The Virginia (VA) AIDS Drug Assistance Program (ADAP) provides access to life-saving medications for the treatment of HIV and related illnesses for low-income clients through the provision of medications or through assistance with insurance premiums and medication co-payments. The program is primarily supported with federal Ryan White (RW) Treatment Extension Act Part B grant funding, which is distributed by a formula based on living HIV and AIDS cases to all states and territories in the United States. VA ADAP provides insurance cost support or directly purchased medications through four service options: Direct ADAP, the Medicare Part D Assistance Program (MPAP), the Insurance Continuation Assistance Program (ICAP) and the Health Insurance Marketplace Assistance Program (HIMAP).
ADAP Enrollment Numbers (as of October 2018)
- Total: 7,362
- Direct ADAP: 2,326
- Medicare Part D Assistance Program (MPAP): 660
- Insurance Continuation Assistance Program (ICAP): 800
- Health Insurance Marketplace Assistance Program (HIMAP, clients in ACA): 3576
Hepatitis C/HIV Co-Infected Treatment Assistance Program Enrollment Numbers (as of April 2018)
- Number of clients that have accessed program: 94
- Number of clients that have completed treatment: 85
- Number of clients in treatment: 3
Clinical Support and Policy Development
In 1996, an ADAP Advisory Committee was created. The committee is comprised of HIV/AIDS medical providers, a pharmacist, and consumers. The committee advises VDH on changes to the formulary, changes in eligibility criteria, adherence issues, and educational concerns. The committee reviews data on ADAP utilization and assess budgetary implications of trends and program changes.
For more information about the committee, please see the ADAP Advisory Committee Scope.
Questions or comments? Medication Eligibility Hotline 1-855-362-0658
Are you ready for Medicaid Expansion? Visit this page frequently for the latest enrollment updates.
Virginia Medicaid Expansion Enrollment Resources
- Medicaid Expansion Flyer for Marketplace Members
- Enrollment Pathways Toolkit
- Virginia Medicaid Expansion and 2019 ACA Open Enrollment
November 21, 2018
You and your family might qualify for Virginia Medicaid’s new health insurance. The new health benefits start on January 1, 2019. Virginia Medicaid sent letters in yellow and white envelopes to people who will get this new insurance. If you have Plan First and GAP, Medicaid will automatically enroll you. If you have SNAP or are a Parent of a Child with Medicaid, you can answer three easy questions to sign up. Cover Virginia can help you sign up online https://www.coverva.org/expansion or phone at 1-855-221-1590. TDD users dial 1-888-221-1590. If you got a letter from Medicaid but lost it, Cover Virginia can tell you whether Medicaid sent you a letter. You can sign up for this new Medicaid insurance any time!
If you had Marketplace insurance last year, you might qualify for this new low to no-cost insurance that will cover your medicines, your doctor and lab visits, and other services. Call Benalytics at 855-483-4647 and they can help you find out which insurance you can get and help you enroll.
Not sure which steps to take? Call the ADAP Hotline at 1-855-362-0658.
The 2019 ACA Open Enrollment period is here!
Enrollment is from November 1, 2018 to December 15, 2018.
Client Letters on Open Enrollment
- If you are a client that receives medication through insurance that VDH pays for, please read this letter (en español).
- If you are a client that receives medication through a local health department or other approved VDH site, please read this letter (en español).
Open Enrollment Updates
Calls are held weekly for those assisting with open enrollment to ask questions. Notes from weekly calls are posted below for reference.
November 21, 2018
2019 Open Enrollment period started November 1 and ends December 15. For this year's enrollment, the ACA module in e2VA will not be used to collect insurance enrollment on clients. The 2019 Insurance Enrollment Worksheet should be completed for each client enrollment. This is a computer-friendly Word document that information can be entered directly into or it can be printed and filled in manually. This is same form used during the prior open enrollment period with only three additional elements: household income, family size, and a Medicaid-eligibility question. If possible, please send the following information with the enrollment worksheet:
- proof of income
- proof of residency in Virginia
- copy of insurance premium data from the Marketplace application
If the enrollment site is a VDH contracted service provider and you have an SFTP (secured) invoice folder (not your SFTP data folder), you may submit documents to the folder. For all others, please fax the documents to 804-864-8050.
In prior years, some enrollment sites recorded each insurance enrollment on an Insurance Enrollment Tracking Log. Sites provide these logs to VDH on a weekly basis to confirm receipt of enrollments submitted. You can still send these logs to VDH this year.
Remember, if clients had Marketplace insurance last year or even insurance through their employers, they might qualify for Virginia Medicaid’s new low to no-cost insurance that will cover medicines, doctor and lab visits, and other services. Benalytics can help clients find out which insurance they can get and help enroll them. Client should call Benalytics at 855-483-4647.
Contact the Medication Access Hotline with any questions about open enrollment at 1-855-362-0658.