Prescription Assistance


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Texas AIDS Drug Assistance Program-Texas

1100 West 49th Street
Austin, TX - 78756
(800) 255-1090

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Program Elegibility

ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. - combined household income must be at or below 200% of the current Federal Poverty Level - must not be eligible for the Texas Medicaid Program - must not exceed Medicaid pharmacy benefits for the month - must not be covered for the medication(s) by any other third-party payer - must be HIV + - current CD4 and Viral Load count must be reported to the Texas Medication Program - must be under the care of a Texas-licensed physician who prescribes the medication(s) - must meet the drug-specific criteria for one or more of the drugs the program offers

Details

An application packet containing instructions & all necessary forms, may be requested by telephoning toll-free 1-800-255-1090. You may download the applcation at: http://www.tdh.state.tx.us/hivstd/meds/document.htm. You may also write to the following address to receive an application: Texas Department of Health Texas HIV Medication Program 1100 West 49th Street Austin, Texas 78756 ATTN: MSJA All applications for new clients must be mailed in to the program. Medical Certification Forms must be submitted for all medication changes. The medical certification forms should only be faxed for clients in immediate need of changes to be made to their approved formulary so as not to disrupt their progress on combination antiretroviral therapy. Newborn infants and pregnant women are a program priority.