Don’t let problems with ADAP prevent you from getting HIV meds
This past summer, the AIDS Drug Assistance Program (ADAP) in California underwent some big changes—resulting in frustrations for clients in the ADAP system, in addition to enrollment workers, pharmacists and medical providers. ADAP is a prescription drug assistance program that helps people access and afford HIV medications.
Critically, the changes have prevented some people living with HIV from being able to pick up their medications at the pharmacy.
“It’s not unusual for me to get a few calls every week from people who are having trouble at the pharmacy and are not able to pick up their medications,” said Ellen Novogrodsky, financial benefits counselor at San Francisco AIDS Foundation. “This wasn’t the case, before. Now, little things are taking a long time to fix. I had a client whose group number wasn’t right, which caused issues. There is an emergency access program to help ensure that people always have access to medications, but it hasn’t always gone smoothly.”
The change to ADAP was a transition from one pharmacy and benefits management contractor (Ramsell Corporation) to three new contractors (A.J. Boggs & Company, Magellan Rx Management, and Pool Administrators). The transition between contractors was “not smooth,” said Novogrodsky, with apparent difficulties in the different agencies communicating with each other. Other issues have stemmed from contractors not having staff available to fix problems that arise after-hours (i.e., weekend and evenings) when people may be more likely to make trips to the pharmacy.
A group of HIV advocacy and AIDS service organizations are currently advocating for ADAP clients and for immediate changes to be made to the system. Until all of the kinks in the ADAP system are resolved, here are tips from Novogrodsky to current ADAP clients:
Pay attention to your mail. Look out for mail about your benefits, and know the names of the new ADAP contractors so you recognize communications from them. There are three new ADAP contractors, but only two that ADAP clients interact with: A.J. Boggs and Magellan Rx. You also might get mail from the California Department of Health related to ADAP.
Remember to re-certify. Every year, you’ll need to re-certify your ADAP before your birthday. You’ll get a letter before your birthday from A.J. Boggs to remind you about this.
Be aware of the mid-year self-verification. Six months after your birthday, you’ll receive a self-verification letter from A.J. Boggs that you’ll need to complete. If there are any changes, you’ll need to see your ADAP enrollment worker.
Leave extra time. We don’t want you to have any disruptions to your medications. Leave plenty of time to complete paperwork, especially if you have moved and have a new address, have changes to your income, or changes to your insurance.
Visit the pharmacy before you completely run out of meds. Give yourself extra time in case there’s a delay.
Get help if you need it. Your ADAP enrollment worker is there to help you. Don’t be afraid to get help if you have questions or otherwise need assistance.
Need help with ADAP? Contact the San Francisco AIDS Foundation Financial Benefits program if you are living with HIV and in the San Francisco Bay Area, and need assistance with services programs including ADAP, Food Stamps, Medi-Cal, Medicare, OA-HIPP, and Social Security. Or call 415.487.8000 if you’d like more information or to schedule an appointment with a benefits counselor.