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The document outlines the Medical Eligibility Form for the New York State Department of Health's Uninsured Care Programs, specifically targeting individuals who are HIV positive. It details the necessary information required from both patients and physicians to assess eligibility for various assistance programs, including ADAP and HIV Home Care. The form includes sections for patient and physician information, medical history, disease staging, and treatment history.

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What is the income limit for ADAP in California?

Eligibility and Enrollment Be HIV positive. Be a California resident. Be 18 or older. Have income at or below 500% of the Federal Poverty Level (FPL) ($75,300 per year for an individual)

Is ADAP part of Ryan White?

Under the Ryan White HIV/AIDS Program (RWHAP) Part B, ADAP provides FDA-approved medications to low-income people with HIV.

What does the Ryan White Program cover?

Eligibility Criteria Medical: HIV-infection or at risk of acquiring HIV infection consistent with the guidelines for Pre-Exposure Prophylaxis. Residency: New York State (U.S. citizenship is not required.) Financial: Financial eligibility is based on 500% of the Federal Poverty Level (FPL).

Who is eligible for ADAP financial eligibility?

Have a positive HIV/AIDS diagnosis; Be at least 18 years old; Have an annual Modified Adjusted Gross Income (MAGI) that does not exceed 600% Federal Poverty Level based on household size and income; Not be fully covered by Medi-Cal or any other third party payers.

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