| Contact |
Mr. Kevin Cranston, MDiv
Director
HIV/AIDS Bureau, Title II
Department of Public Health
250 Washington Street, 3rd floor
Boston, MA 02108-4619
Phone: (617) 624-5303
Fax: (617) 624-5399
Public Contact Number: (800) 228-2714
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| Website |
http://www.state.ma.us/dph/aids/services/guide/financial_asst.htm |
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AIDS Hotline |
(800)443-2437 |
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| Financial Eligibility |
- <$50,000 net annual income, limit raised by $2,900 for each dependent.
- Massachussetts residency required.
- Must be re-certified every six months.
- US citizenship not required.
- No age restrictions.
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| Medical Eligibility |
- HIV +
- Referral by a physician.
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| Enrollment |
For enrollment contact:
The documentation required is listed below.
1.Proof of Address -
- Copy of a current Massachusetts' Driver's License
- Recent utility bill
- Postmarked envelope
- If homeless, letter from case manager or shelter (P.O Box may not be used as proof of address)
2.Verification of all income from any source listed in the application.
If you receive:
- Public or private benefits - a copy of recent benefit check and benefits verification statement from payer (verification must be no more than 60 days old)
- Earned income - copies of two of four most recent pay stubs, quarterly tax returns if self-employed, other letters or statements
- No income - letter indicating same
- All signatures must be original
3.Verification of insurance or application for insurance
- If on MassHealth with spenddown, a copy of letter from MassHealth (notify HDAP immediately upon meeting spenddown)
- If MassHealth application is pending, include letter indicating application date
- If MassHealth application was rejected, copy of denial letter
- If insured, provide copy of insurance card. If applying for a co-pay coverage and co-pay amount is not indicated on insurance card, provide statement indicating co-pay amounts
- If uninsured, or if insurance does not include prescription coverage, provide letter from employer stating this (if you can not obtain information from your employer, then you must provide a statement indicating so)
4.Application Form
- Please complete all questions and have your physician complete and sign the physician portion of the application
5.Client certification and authorization statement
- Read and sign the statement
6.Case Management Benefits Screening Form
- Indicate all forms of assistance applied for if you need full coverage from HDAP
- Please complete information indicating where you receive Case Management Services
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| Other Services |
The Comprehensive Health Insurance Initiative (CHII) helps eligible Massachusetts residents who are living with HIV and are currently uninsured and meet HDAP eligibility to purchase a comprehensive health insurance plan that offers full prescription drug coverage. CHII pays the health plan's required monthly premiums and prescription co-payments for HDAP approved drugs. HDAP/CHII can help self employed individuals enroll in health insurance plans at any time during the year. Others may be able to obtain health insurance during certain times of the year, or anytime if they've recently lost insurance (must complete application within 60 days of loss) or have just arrived in Massachusetts (must complete application within 30 days of arrival in the state). CHII can also pay COBRA premiums, private health insurance premiums and employee contribution to health insurance premiums for eligible individuals and families. All information given to CHII is kept strictly confidential.
To apply to CHII or learn more about it, call (800) 228-2714 or go to www.crine.org
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