New Jersey
This information has not yet been verified by New Jersey or the persons listed on the New Jersey pages. Please contact us if you have changes or corrections. Thank You.
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Ronald Weinstein
ADDP (ADAP) Program Coordinator
New Jersey Department of Health
e-mail: ronald.weinstein@doh.state.nj.us
New Jersey Toll-free: (877) 613-4533
Public Contact Number: (609) 984-6125
ADDP Eligibility
- HIV + (an AIDS diagnosis is not required)
- Must present a letter from a physician that certifies the medical necessity of receiving the covered medication(s).
- Annual recertification required.
Enrollment - Must be a New Jersey resident 30 days prior to the date of your application.
- Must present a letter from a physician that certifies the medical necessity of receiving the covered medication(s).
- Must sign a consent form which attests to the accuracy of the information and allows for verification.
- Must have received the maximum benefits allowable under other forms of reimbursement (Medicaid, PAAD, private insurance).
Pharmacy - Any Medicaid Eligible Pharmacy/Pharmacist in New Jersey.
Other Services- Health Insurance Continuation Program (HICP)-
This program allows you to keep your health insurance when you can no longer work or when you can only work part time. HICP will pay the monthly payments (premiums) for your health insurance, including family insurance that covers your spouse and/or children. HICP helps you keep the health insurance you have, even privately purchased insurance. Call 1-800-353-3232 for details.
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- State and National Resources - New Jersey specific contact information for different programs through which you can access a variety of services. This page also includes national resources, and links to other sources.
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New Jersey Resources and HIV Care Providers :
New Jersey has Resources that can either provide or refer you to a case manager or a health care provider. This is funded by the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The participating agencies are listed, as are some other resources.
- Accessing Treatments and other Resources : New Jersey has an open formulary, and covers services through other programs as well. Other potential sources of treatments for people with HIV or Hepatitis are also listed.
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Hepatitis Resources : New Jersey has Hepatitis vaccination programs, and covers some treatments for hepatitis B and Hepatitis C through their program.
Waiting List? - Sometimes a state has a waiting list people have to stay on until spaces become available. Check to see if there is a waiting list for the program by contacting them directly. According to NASTAD's most recent ADAP Watch . New Jersey does not have a waiting list. Otherwise, you may need to try a Patient Assistance Program or apply for Medicaid or Medicare or private insurance. Do not ever drop your private insurance without first seeing if your state will cover part or the whole premium, especially if you have children.
- Patient Assistance Programs : the pharmaceutical industry has set up programs that offer medications for free, or at a very low price. You may have to apply directly to a specific company, or use a national service set up by a group of companies called pparx.org. There are also other companies that charge a fee for applying to these programs. Your doctor or another member of your health care team like a case manager will usually help you out to apply, although some times you need to apply to more than one company. A group called the HIVMA is working towards getting the extra resources that help your health care team to provide care, and to help you do things like apply for these programs.
- Medicaid - HIV medications are covered by government programs and most private insurance. Many people with HIV disease are covered by Medicaid. If your are on Medicaid there is a wide range of services and care that are covered. You will be switched over to Medicaid if you become eligible for that program while on ADAP. This may happen if, for example, you are using ADAP to help you with your Spenddown. If you have any questions contact The Access Project (network@atdn.org) and we'll help to explain how this affects your access to drugs and care for HIV and related conditions.
- Medicare and Medicare Part D - Some people with HIV are on Medicare. Many people must apply for a Medicare Part D program to cover the costs of their medications. If you are eligible for Medicare Part D, then you will probably be switched to that instead of ADAP. In some cases ADAP will then pay for your co-pays for drugs and possibly even your Medicare Part D monthly premium. Once you reach a certain point with regards to drug expenses, however, you must somehow cover a $2,700 expense, called the doughnut hole, before your drugs are covered again by Medicare Part D. Some people end up joining ADAP again because they just don't have the money. Each state is different right now, so keep in close contact with your case manager to make sure you know of all your access options. As with Medicaid, contact us if you have questions that have not been answered by the websites listed here, your health care providers or your Case Manager. We will also go over what your case manager has set up if you like, or provide you with case management support and resources.
- Confused or Have Questions? You can always contact The Access Project (theaccessproject@atdn.org) by e-mail or phone and ask questions about all this information. We are a non-profit, community based organization whose goal is to help you access the care and resources you need. There are also many excellent resources that provide extensive descriptions and information about these programs. Check out NASTAD's list of publications for comprehensive descriptions of Medicaid, Medicare, Medicare Part D, ADAP and other important topics. Other links are also listed throughout The Access Project and the AIDS Treatment Data Network website pages.
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