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Follow-up to Coinsurance Question
Apr 18, 2014

In your initial response you said:

"AIDS Drug Assistance Programs (ADAP) vary by state, and I assume this is the copay assistance program you're speaking of. Generally, the answer to your question is that ADAP will pay what the insurance doesn't pay as long as the medication is on the ADAP formulary. That would be whether it is a copay or coinsurance percentage.

You should confirm that with the ADAP program in your states. Or check with your pharmacist. He or she should know.

If you were not speaking of an ADAP program, give me the details of the program and I'll try to confirm it.

Good luck, Jacques"

I think we might be talking about different things. I wasn't referring to a government assistance program. I was speaking of the copay assistance provided by Pharma companies as seen below:

Thank you!

Response from Mr. Chambers

Thank you for clarifying that. Those programs are designed and administered by each pharmaceutical manufacturer. They are voluntary programs so there are no overall rules they must follow. Because they are run by the manufacturers, they can set the rules, decide the income limits, and determine what benefits they will provide. They may even have an appeal system, but that would be up to each program.

You may want to check with your state to see if they do offer an ADAP plan that can help you with medications. If you don't have a nearby AIDS Service Organization that can guide you on that, do a browser search for: AIDS Drug Assistance Program (and name your state).

Good luck, Jacques

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