Will your state ADAP coordinate with marketplace plans? NASTAD has answers.

| December 31, 2013

ADAPDon’t know if your state AIDS Drug Assistance Program (ADAP) will be able to help pay premiums or co-pays for medications for health insurance plans purchased on the marketplaces?  Check out this survey to find out what your state ADAP can do.

With Affordable Care Act (ACA) provisions requiring insurance companies to sell policies without discrimination based on pre-existing conditions, people with HIV now have greater access to new coverage options in the marketplace. This means people with HIV will continue to need help from the AIDS Drug Assistance Program (ADAP) to afford medications.

To shed light on the ways ADAPs can coordinate with health insurance, the National Alliance of State and Territorial AIDS Directors (NASTAD) conducted a survey to assess the status and structure of ADAP/Ryan White Part B insurance purchasing programs and created a fact sheet and chart to highlight the current structure of these programs as well as future plans to assist clients with the costs associated with new insurance coverage options available.

Today, four states (Arkansas, North Carolina, Mississippi, and Pennsylvania) cannot provide insurance purchasing assistance.  Two of the states (Arkansas and Mississippi) told NASTAD they are developing the capacity to do so.  When asked if they were going to pay premiums for marketplace plans, ten states said they “unsure” or “planning” to do so.

ADAPs traditionally provided access to medications through direct distribution to eligible clients. However, as the health care landscape has changed and more ADAP clients are able to access public and private insurance coverage, ADAP’s are adapting. They are assisting to assisting with insurance for clients, provide assistance with variety of coverage types and are adapting their systems and infrastructure to ensure access to new coverage options.

Read the full fact sheet.

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