Application Process | VA MAP Service Options | Criteria | Recertification | VA MAP Forms
1-855-362-0658 (phone) / 1-804-864-8050 (fax)
Application Process
To enroll in VA MAP clients must apply through the VA MAP Central Office or through the Virginia Commonwealth University Health Systems (VCUHS) Financial Services (if clients receive services there). Incomplete applications will be returned to provider/sender and no further action will be taken.
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- Clients may complete the application themselves and mail and/or fax to the VA MAP Central Office (Fax 1-804-864-8050, Toll Free Fax 1-877-837-2853, Mailing address: Virginia Department of Health, HCS Unit, 1st Floor, James Madison Building, 109 Governor Street, Richmond, VA 23219).
- Clients may call the Eligibility & Medication Call Center (1-855-362-0658), and staff will help with the application process. The application will be mailed to the client to sign and provide supporting documents.
VA MAP Service Options
1. Direct Medication Assistance Program (Direct MAP): If a client does not have any other coverage for their HIV/AIDS medications, medications can be picked up at your local Walgreens using a Ramsell card, VDH’s Pharmacy Benefits Manager.
- Enrolled clients receive a 30-day supply of medication at a time.
- Clients may elect to get medication(s) via mail order.
- All medications on the VA MAP Formulary is available; please review the formulary on our website.
2. Medicare Prescription Assistance Program (MPAP): VA MAP clients who are enrolled in Medicare can receive help with monthly premiums and cost shares. Cost shares are medication deductibles and medication co-payments. VA MAP will assist with co-payments for medications on the Medicare formulary. Clients can pick up medications at any pharmacy that accepts their Medicare plan and is within the Ramsell network.
3. Insurance Continuation Assistance Program (ICAP): Individuals with certain private insurance with medication benefits are eligible for VA MAP assistance with their medication co-payments and deductibles if all other qualifications are met. At any point in time a client loses insurance, the client can access medications through the Direct Medication Assistance Program if the client continues to meet VA MAP eligibility criteria.
Medication copayment assistance will cover medications on the VA MAP Formulary.
4. Health Insurance Marketplace Assistance Program (HIMAP): VA MAP supports costs for insurance premiums and medication cost shares for clients who enroll in VDH approved plans under the federal Insurance Marketplace under the Affordable Care Act. Please refer to the Affordable Care Act page for approved plans.
Criteria
Insurance Coverage: Each applicant will be screened by VA MAP or a VDH third-party vendor (Benalytics) to see if they have or are eligible for health insurance. VA MAP may be able to help with client cost shares (medication deductibles and co-payments) under some insurances.
Medicaid: Clients must not qualify for or have Medicaid. If a client loses their Medicaid coverage, VA MAP can provide medication assistance.
- If a Ryan White client is identified as being Medicaid eligible, they cannot be approved to receive VA MAP services until a Medicaid denial letter is received.
VA MAP Disenrollment Due to Medicaid Coverage
Under HRSA payer of last resort requirements, program participants must utilize payer sources other than Ryan White HIV/AIDS Program (RWHAP) funds to access medications and other core and support services if they are eligible. If a client currently enrolled in the Virginia Medication Assistance Program (VA MAP) is eligible for Medicaid, that client will be removed from VA MAP services. The purpose of this policy and procedure, the steps of which are posted below, is to transition clients enrolled in Virginia Medicaid out of VA MAP, ensuring reasonable steps are taken to educate clients about using their Medicaid coverage for medication access.
Questions or comments?
Medication Eligibility Hotline 1-855-362-0658