ADAP - Eligibility, Enrollment Process and Provider Information
Eligibility Criteria
- Residency: New York State (U.S. citizenship is not required.)
- Medical: ADAP, ADAP Plus and APIC
- HIV-infection (asymptomatics are eligible.)
- Home Care: AIDS or HIV illness and chronic medical dependency due to physical or cognitive impairment from HIV infection.
- Financial: Income less than $44,000/year for a household of one, $59,200 for two, and $74,400 for three or more and liquid assets less than $25,000
Enrollment Process
A single application form can be used to enroll in ADAP, ADAP Plus and the HIV Home Care Program, an additional application is required for APIC. Applicants apply to the program, providing proof of residency, income and assets. A Medical Application signed by a licensed medical professional is required, verifying HIV-infection and indicating the applicant's medical status. A treatment plan by a physician must also be submitted for Home Care applicants. Enrollment in the programs is coordinated for all eligible individuals. Upon determination of eligibility, an Enrollment Card is issued which may be used to receive care from an enrolled provider. The programs provide an automated eligibility verification system to allow providers to confirm participant eligibility status.
Providers
ADAP has enrolled over 3,000 local pharmacies statewide. Any pharmacy enrolled in the New York State Department of Health Elderly Pharmaceutical Insurance Coverage Program (EPIC) is eligible to join the ADAP pharmacy network.
ADAP plus has enrolled over 165 Article 28 health care providers (over 344 service sites). These providers are hospitals, clinics and drug treatment programs who have been approved for the HIV Primary Care Medicaid Program. All facilities provide a full range of HIV primary care services. In December of 1993, ADAP Plus began enrollment of private physicians. A total of over 800 physicians have enrolled. Eligible physicians must be enrolled in the Medicaid HIV Enhanced Fees for Physicians (EFP) Program. Over 110 laboratories are also enrolled to provide laboratory and ancillary services. Laboratories must be certified by the New York State Department of Health and participate in Medicaid.
The HIV Home Care Program has provider agreements with over 300 Home Health Agencies, Long Term Home Health Care Programs, Hospices and Licensed Home Care Services Agencies. Home Care agencies are screened through the New York State Department of Health Bureau of Long Term Care.
