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ADAP Criteria and Formularies

Introduction to the AIDS Drug Assistance Program

ADAPThe AIDS Drug Assistance Program (ADAP) is federally-funded, but it is state administered. The amount of money each state receives depends on the number of documented AIDS cases in the state. States with a lot of AIDS cases get a lot of money for their ADAP program, while others get very little. Some add state money to the amount they get from the federal government, and some do not. As a result, the qualifications for ADAP and the drugs the program covers vary widely from state to state!

Every year we contact each state to get their latest information. We don’t know of any other print publication that does this.

Here’s the information we provide for each state, using Alabama, the first state on the list, as an example.

Underneath the state’s name, you’ll see the phone number for their ADAP program. We urge you to call the number for your state to confirm their latest information. We do our very best to make this list accurate, but sometimes we make mistakes. Sometimes the states make mistakes, too, and changes may have been made since press time.

Below the phone number is the maximum qualifying income for a single person to receive assistance from ADAP. In Alabama this year it is $48,560 - that’s the most you can make and still get your drugs through the Alabama ADAP. In Texas, Iowa and a few other states, it is only $24,280. But in California it is $60,700 - more than two-and-a-half times as much as Texas!

Below that we let you know if the state has a waiting list, and we give you their web address if they have a website.

Lastly, we give you each state’s “formulary,” a list of the drugs that state’s ADAP program covers. As you can see, this also varies dramatically! Alabama covers only a few of the basics. You can see at a glance that Arizona covers more than three times as many. Some states have an “open formulary,” which means that the state covers most FDA-approved drugs for the treatment of HIV and the side-effects of HIV medication.

*See below for individual state links.


Click on a state below to view individual ADAP information

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida,
Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts,
Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico,
New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina,
South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming



ALABAMA

866-674-9964 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.alabamapublichealth.gov/hiv/adap.html

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir; albuterol; amlodipine; amoxicillin; amphotericin B; amprenavir; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; benazepril; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; carbamazepine; cephalexin; cidofovir; citalopram; clarithromycin; clindamycin; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epoetin alfa; escitalopram; ethambutol; etravirine; famciclovir; fenofibrate nanocrystallized; fluconazole; flucytosine; fluoxetine; fosamprenavir; foscarnet; gabapentin; gardasil IM; glecaprevir/pibrentasvir; glyburide; glyburide metformin; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B virus vaccine-injection; hydroclorothiazide; imiquimod; indinavir; interferon alfa-2a; interferon alfa-2b; ipratropium + albuterol; isoniazid; itraconazole; ketoconazole cream/shampoo/tablets; lamivudine; lamivudine/zidovudine; lamotrigine-oral; leucovorin; levetiracetam; lisinopril; lithium ER-oral; lopinavir/ritonavir; maraviroc; megestrol; metformin HCL; metronidazole; minocycline; moxifloxacin; nelfinavir; nevirapine; nortriptyline; paroxetine; peg-interferon alfa-2a; peg-interferon alfa-2b; penicillin VK; pentamidine; pneumococcal vaccine; pravastatin; prednisone; probenecid; promethazine HCL; pyrazinamide; pyrimethamine; raltegravir; ribavirin; ribavirin/interferon alfa-2b; rifabutin; rilpivirine; risperidone-oral; ritonavir; rosuvastatin; saquinavir; sertraline; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; trazadone; valacyclovir; valganciclovir; voriconazole; zidovudine; ziprasidone-oral.


ALASKA

907-263-2050 (ADAP)
Maximum qualifying income (single): $60,720
Website: www.alaskanaids.org/index.php/client- services/adap

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir dipivoxil; amphotericin B; atazanavir; atazanavir/cobicistat; atorvastatin calcium; atovaquone; azithromycin; cidofovir; clarithromycin; clindamycin; clotrimazole; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate and atropine; dolutegravir; dolutegravir/lamivudine/abacavir; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fomivirsen; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; hepatitis A vaccine; hepatitis B vaccine; indinavir; influenza vaccine; interferon alfa; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin calcium; loperamide HCL; loperamide HCL and simethicone; lopinavir/ritonavir; maraviroc; megestrol acetate; nelfinavir; nevirapine; nystatin suspension; oseltamivir; pantoprazole sodium; peg-interferon alfa-2a; pegylated interferon alfa-2b; pentamidine aerosolized; pentavalent antimony; pneumococcal vaccine; pravastatin sodium; prednisone; probenecid; prochlorperazine; promethazine; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; rosuvastatin calcium; saquinavir; simvastatin; stavudine; sulfadiazine; tenofovir; testosterone; tipranavir; TMP/SMX; valacyclovir; valganciclovir; varicella zoster immune globulin; zanamivir; zidovudine.


ARIZONA

602-364-3610 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.azadap.com

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acetaminophen/codeine; acetaminophen/hydrocodone; acetaminophen/oxycodone; albuterol metered-dose inhaler; alendronate; amitriptyline; amlodipine; amoxicillin; amoxicillin/clavulanate; acyclovir; aripiprazole; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azelastine HCL; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; beclomethasone; beclomethasone dipropionate; benazepril; bupropion SR; carbamazepine; calcium carbonate; calcium carbonate/vitamin D; calcium citrate; calcium citrate/vitamin D; cefpodoxime; cephalexin; chloralphenazone/isometheptene/acetaminophen; chlorhexidine mouthwash; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonazepam; clotrimazole oral troches; cobicistat; cyclobenzaprine; daclatasvir; dapsone; darunavir; darunavir/cobicistat; delavirdine; desipramine; dicloxacillin; dicyclomine; didanosine; diazepam; diltiazem sustained release; diphenoxylate/atropine; diphenydramine; divalproex; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxazosin; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; entecavir; epoetin alfa; escitalopram; estradiol; estrogen conjugated; ethambutol; etravirine; ezetimibe; ferrous sulfate; fenofibrate; filgrastim; fluconazole; flunisolide; flunisolide MDI; fluocinonide cream/ointment; fluoxetine; folic acid; fosamprenavir; furosemide; gabapentin; gemfibrozil; glipizide; glyburide; guaifenesin with codeine cough syrup; hctv; hctv/triamterene; hydrocortisone cream/ointment; hydroxyzine; ibuprofen; imiquimod cream; indinavir; insulins; ipratropium HFA; isoniazid; itraconazole; ketoconazole cream/shampoo; lamictal; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; leucovorin; levetiracetam; levothyroxine; lisinopril; lithium carbonate; loperamide; lopinavir/ritonavir; loratidine; lorazepam; losartan; magnesium oxide; maraviroc; medroxyprogesterone; megestrol; metformin; methodone; methylphenidate; metoclopramide; metoprolol; metronidazole; miconazole vaginal; mirtazapine; mometasone; morphine sulfate immediate release; morphine sulfate sustained release; moxifloxacin; multivitamin with 1 mg folate/pre-natal vitamins; mupirocin ointment; naloxone; naproxen; nelfinavir; nevirapine; nevirapine; niacin sustained release; nortriptyline; nystatin suspension; olanzapine; ombitasvir/paritaprevir /ritonavir; omeprazole; ondansetron; opium tincture; oseltamivir phosphate; oxycodone immediate release; pancrelipase; paroxetine; peginterferon alfa-2b; penicillin VK; pentamidine isethionate; phenytoin; pioglitazone; podofilox solution; potassium chloride; pozaconazole; pravastatin; prazosin; prednisone; pregabalin; prochlorperazine; promethazine; propranolol; pseudoephedrine; pyrazinamide; pyridoxine; pyrimethamine; quetiapin; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosuvastatin; saquinavir; selenium sulfide; sertraline; simeprevir; sitagliptin; sofosbuvir; spironolactone; stavudine; sulfadiazine; temazepam; tenofovir; tenofovir alafenamide; testosterone; testosterone cypionate; testosterone enanthate; testosterone gel; tipranavir; TMP/SMX; tramadol HCL; trazodone; triamcinolone cream/ointment; trimethoprim; valganciclovir; venlafaxine; viekira pak; voriconazole; warfarin; zidovudine; zolpidem.


ARKANSAS

501-661-2862 (ADAP)
Maximum qualifying income (single): $24,280
Website: www.healthy.arkansas.gov/programs-services/topics/ryan-white-program


Abacavir; abacavir/dolutegravir/lamivudine; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amlodipine; amlodipine/benazepril; atazanavir; atazanavir/cobicistat; atenolol; atovaquone; azithromycin; bisoprolol/HCTZ; bupropion; bupropion SR; bupropion XL; citalopram; clarithromycin; clotrimazole troches; cobicistat; dapsone; darunavir; darunavir/cobicistat; didanosine; diltiazem; dolutegravir; doxycycline; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/tenofovir alaf- enamide; emtricitabine/tenofovir DF; enfuvirtide; esomeprazole; ethambutol; etravirine; ezetimibe; famotidine; fenofibrate; fluconazole; fluoxetine; fosamprenavir; furosemide; gabapentin; gemfibrozil; lansoprazole; leucovorin; lisinopril; lisinopril/hctz; loperamide; lopinavir/ritonavir; maraviroc; megestrol; megestrol ES; metformin; metoprolol XL; mirtazapine; nelfinavir; nevirapine; nifedipine XL; nystatin; omeprazole; ondansetron; pantoprazole; paroxetine; posaconazole; potassium chloride; pravastatin; prednisone; promethazine; propranolol; pyrimethamine; raltegravir; ramipril; ranitidine; rifabutin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; spironolactone; stavudine; sulfadiazine; sumatriptan; telmisartan; telmisartan hydrochlorothiazide; tenofovir disoproxil fumarate; terazosin; tipranavir; TMP/SMX; trazadone; triamterene/hctz; valacyclovir; valganciclovir; venlafaxine; verapamil; verapamil CD; verapamil SR; voriconazole; zidovudine.


CALIFORNIA

844-421-7050 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.cdph.ca.gov/Programs/CID/DOA/Pages/OAadap.aspx#

Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acyclovir; albendazole; alitretinoin gel; alprazolam; amikacin sulfate; amitriptyline; amoxicillin; amphotericin B; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bleomycin; bupropion; buspirone; capreomycin; caspofungin; cephalexin; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clofazimine; clotrimazole; cobicistat; codeine sulfate; codeine/APAP; codeine/ASA; crofelemer; cyclophosphamide; w/wo ASA/ APAP; cyclophosphamide; cycloserine; dapsone; darunavir; darunavir/cobicistat; daunorubicin, delavirdine; desipramine; dexamethasone; dextroamphetamine; dicloxacillin; didanosine; diphenoxylate/atropine; divalproex; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxorubicin; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; epoetin alpha; erythromycin base/ ethylsuccinate/stearate; ethambutol; ethionamide; etravirine; famciclovir; famotidine; fenofibrate; fenoprofen; fentanyl; filgrastim; fluconazole; flucytosine; fluoxetine; fomivirsen; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; glipizide; glyburide/metformin; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/hepatitis B vaccine; hydrocodone/APAP; hydrocodone/ibuprofen; hydroxyurea; ibuprofen; imipenem/cilastatin; imiquimod; indinavir; indomethacin; interferon alfa-2a; interferon alfa-2b; interferon alphacon 1; interferon alfa-N3; isoniazid; itraconazole; ketoconazole; ketoprofen; ketoralac tromethamine; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; leucovorin; levofloxacin; levorphanol; linezolid; loperamide; lopinavir/ritonavir; lorazepam; maraviroc; megestrol; metformin; methadone; methotrexate; methylphenidate; metoclopramide; metronidazole; minocycline HCL; mirtazapine; morphine sulfate; moxifloxacin; nandrolone; naproxen; nefazodone; nelfinavir; neomycin sulfate; nevirapine; nortriptyline; nystatin; olanzapine; omeprazole; opium tincture; oxandrolone; oxycodone; oxycodoneAPAP; oxycodone/ASA; paclitaxel; pancrelipase; para-aminosalicylate; paromomycin; paroxetine; pegylated interferon; penicillin G benzathine; penicillin V potassium; pentamidine; phenytoin; pioglitazone; pneumococcal vaccine; pravastatin; prednisone; probenecid; prochlorperazine; promethazine; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; ribavirin/interferon alfa 2B; rifabutin; rifampin; rifampin/isoniazid; rilpivirine; risperidone; ritonavir; rosiglitazone maleate; rosuvastatin; saquinavir; sertraline; simeprevir; simvastatin; sofosbuvir; somatropin; stavudine; sulfadiazine; sulindac; tenofovir; testosterone; tetracycline; tipranavir; TMP/SMX; trazadone; trimethoprim; trimetrexate; valacyclovir; valganciclovir; vancomycin; venlafaxine; vinblastine; vincristine; voriconazole; zaprasidone; zidovudine.


COLORADO

303-692-2716 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.stdhivco.org

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprosate calcium; acyclovir; adefovir; amoxicillin; amphotericin injection; aripiprazole; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; aviane and generics; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; boceprevir; buproprion; chlorhexidine rinse; cidofovir; citalopram; clarithromycin; clindamycin; clotrimazole; cobicistat; contraceptives; daclatasvir; dapsone; darbepoetin alfa; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epoetin alfa/erythropoietin; etravirine; esomeprazole; ethambutol; famciclovir; fenofibrate; filgrastim; fluconazole; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; glucometer; glucose strips; glyburide; hydrochlorothiazide; ibalizumab-uiyk; indinavir; insulin; itraconazole; lamivudine; lamivudine/zidovudine; lancets; leucovorin; levetiracetam; lisinopril; lisinopril/hctz; loperamide; lopinavir/ritonavir; losartan; maraviroc; metformin; metformin/glyburide; metoprolol; metronidazole; mirtazpine; necon 1/35 and generics; nelfinavir; nevirapine; nitazoxanide; nystatin suspension; olanzapine; ombitasvir/paritaprevir/ritonavir; pegfilgrastim; peginterferon alfa-2a; peginterferon alfa-2b; penicillin; pentamidine/aerosol; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rilipivirine; risperidone; ritonavir; rosuvastatin; saquinavir; sertraline; sofosbuvir; sofosbuvir/velpatasvir; stavudine; sulfadiazine; telaprevir; telbivudine; tenofovir; tesamorelin; testosterone; tipranavir; TMP/SMX; vaginal ring; valacyclovir; valganciclovir; varenicline; venlafaxine; voriconazole; zidovudine; ziprasidone.


CONNECTICUT

800-233-2503 (ADAP)
Maximum qualifying income (single): $47,520
Website: www.ct.gov/dss/cadap

Abacavir; abacavir/lamivudine; abacavir/dolutegravir/lamivudine abacavir/lamivudine/zidovudine; acetaminophen with codeine; acyclovir; albuterol; alclometasone dipropionate; alendronate; alendronate sodium/cholecalciferol; alprazolam; amitriptyline HCL; amlodipine; amoxicillin; amoxicillin/clavulanate pot.; amphotericin B; ampicillin; amprenavir; aripiprazole; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azelastine HCL; azithromycin; benztropine mesylate; betamethasone; bictegravir/emtricitabine/tenofovir alafenamide; budesonide; bupropion HCL; buspirone; calcium supplements; carbamazepine; cefditoren pivoxil; ceftriaxone; cefuroxime; celecoxib; cephalexin; chlorhexidine gluconate; cholestyramine; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clindamycin gel; clobetasol propionate; clofibrate; clonazepam; clopidigrel; clotrimazole; cobicistat; colesevelam HCL; comvax; dapsone; darunavir; darunavir/cobicistat; delavirdine; desloratadine; dexamethasone; diazepam; dicloxacillin; didanosine; digoxin; diltiazem HCL; diphenoxylate HCL; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline hyclate; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril maleate; enfuvirtide; engerix-B; entecavir; erythropoietin; escitalopram oxalate; esomeprazole; ethambutol; etravirine; exenatide; ezetimibe; famciclovir; famotidine; fenofibrate; fenofibric acid; fentanyl transdermal system; ferrous sulfate; filgrastim; flucinonide; fluconazole; fluoxetine HCL; flunisolide; fluticasone propionate; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gatifloxacin; gemfibrozil; gentamicin; glipizide; glyburide; guaifenesin/codeine PH; guaifenesin/DM HBr; guaifenesin/pseudoephedrine; granisetron; havrix; hydrochlorothiazide; hydrocortisone topical; hydroxyurea; hydroxyzine HCL; ibuprofen; imiquimod; indinavir; insulin NPH; insulin Regular; ipratropium bromide; isosorbide dinitrate; isosorbide mononitrate; itraconazole; ketoconazole; ketoconazole 2%; ketoprofen; labetalol HCL; lactic acid; lactulose; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; leucovorin; levocarnitine/oral; levofloxacin; levothyroxine sodium; lisinopril; lithium; loperamide HCL; lopinavir/ritonavir; lorazepam; maraviroc; megestrol acetate; meningococcal vaccines; metformin HCL; metronidazole; metronidazole cream; metroprolol succinate; minocycline HCL; minoxidil; mirtazapine; mometasone furaote monohydrate; mupirocin ointment.; nandrolone decanoate; naproxen; nelfinavir; neomycin sulfate; nevirapine; nitrofurantoin monohydrate; nitroglycerin; nortriptyline HCL; nystatin; ofloxacin; olanzapine; omega-3 acid ethyl esthers; ondansetron; oseltamivir; oxandrolone; oxycodone with APAP 5/325; oxycodone with APAP SLN; oxycodone HCL – CR; oxymetholone; pantoprazole sodium; paromomycin; paroxetine; peg-interferon alfa-2a; peg-interferon alfa-2b; penicillin G benzathine; penicillin V potassium; pentamidine; pioglitazone HCL; pneumococcal vaccine; pravastatin; prednisone; pimecrolimus; primaquine; prochlorperazine; pyrimethamine; quetiapine fumarate; rabeprazole sodium; raltegravir; ranitidine HCL; recombivax HB; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosiglitazone maleate; rosuvastatin; salmeterol; salmeterol xinafoate; saquinavir; sertraline; somatropin; spironolactone; stavudine; strovite/forte/plusd/advance/one; sulfadiazine; temazepam; tenofovir; terbinafine; terconazole; testosterone; testosterone cypionate; testosterone gel; tipranavir; TMP/SMX; tramadol HCL; trazadone; triamcinolone acetonide; trimethoprim; twinrix; valacyclovir; valganciclovir; valsartan; valsartan and HCT; vancomycin; vaqta; venlafaxine; verapamil; vitamin D supplements; voriconazole; zalcitabine; zanamivir; zidovudine; zolpidem tartrate; zoster vaccine - recombinant, adjuvanted.


DELAWARE

302-744-1050 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.ramsellcorp.com/individuals/de.aspx

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acetaminophen/oxy-
codone; acyclovir; adult diapers; albuterol inhaler; albuterol/ipratropium; alendronate; alprazolam; amikacin sulfate; amitriptyline; amlodipine; amlodipine/atorvastatin; amoxapine; amoxicillin; amoxicillin/potassium clavulanate; ampicillin; amprenavir; apresonline; aripiprazole; asenapine; aspirin; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azelastine; azithromycin; beclomethasone; benztropine; bictegravir/emtricitabine/tenofovir alafenamide; brompheniramine; budesonide; bupropion; buspirone; carafate; carbamazepine; carvedilol; catheters; cefixime; cefuroxime; cephalexin; cetirizine; chlordiazepoxide; chlorpromazine; cholestyramine; cidofovir; ciprofloxacin; citalopram; clarithromycin; clemastine; clindamycin; clomipramine; clonazepam; clonidine; clorazepate; clotrimazole troches; clotrimazole vaginal; codeine with pain relievers; colesevelam; cyproheptadine; dapsone; darunavir; darunavir/cobicistat; delavirdine; desipramine; desloratadine; desvenlafaxine; dexamethasone; dexlansoprazole; dexchlorpheniramine; dexlansoprazole; diabetic supplies; diazepam; diclofenac; dicloxacillin; didanosine; digoxin; diltiazem; diphenhydramine; diphenoxylate/atropine; disposable syringes; docusate-sennoside; dolutegravir; doxycycline; duloxetine; econazole nitrate 1% cream; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; epoetin alpha; erythromycin base/succinate/stearate; escitalopram; esomeprazole; estazolam; ethambutol; ethosuximide; etodolac; etravirine; ezetimibe; ezetimibe/simvastatin; famciclovir; famotidine; felodipine; fenofibrate; fenofibrate micronized; fenoprofen; fentanyl transdermal system; ferrous sulfate; fexofenadine; filgrastim; florinef acetate; fluconazole; flunisolide; fluocinonide; fluoxetine; flurazepam; flurbiprofen; fluticasone; fluticasone/salmeterol; fluvoxamine; fomivirsen; fosamprenavir; foscarnet; fosinopril; furosemide; gabapentin; ganciclovir; gatifloxacin; gemfibrozil; glimepiride; glipizide; glyburide; haloperidol; hemorrhoidal creams & suppository; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; human papillomavirus quadrivalent; hydrochlorothiazide; hydrocodone and derivatives; hydrocodone/IBU; hydrocortisone; hydromorphone and derivatives; hydroxyzine; ibandronate; ibuprofen; imipenem/cilastatin; imipramine; imiquimod; indinavir; influenza/vaccine/seasonal; insulins; inteferon alfa-2b; interferon alfa-2b + ribavirin; ipratropium; isoniazid (INH); isoproterenol; isradipine; itraconazole; ketoconazole; ketoconazole cream; ketoprofen; ketorolac; labetalol; lamivudine; lamivudine/zidovudine; lamotrigine; lancets; lansoprazole; leucovorin; levetiracetam; levofloxacin; levothyroxine; linezolid; lisinopril; lithium carbonate; loperamide; lopinavir/ritonavir; loratadine; lorazepam; losartan; lovastatin; lurasidone; maprotiline; maraviroc; meclofenamate; meloxicam; meperidine; metaproterenol inhaler; metformin; metformin/repaglinide/rosiglitazone/sitagliptin; methylprednisone; metolazone; metoprolol; metronidazole; miconazole cream; minocycline HCL; minoxidil; mirtazapine; montelukast; morphine sulfate; moxifloxacin; mycostatin; nabumetone; nandrolone; naproxen; nefazodone; nelfinavir; neomycin sulfate; nevirapine; niacin; nifedipine; nitrofurantoin; nizatidine; nortriptyline; nystatin cream; ofloxacin; olanzapine; olmesartan; omega-3-acid ethyl esters; omeprazole; ondansetron; oxandrolone; oxaprozin; oxazepam; oxycodone/ APAP; paliperidone; pancrease enzymes; pantoprazole; paromomycin; paroxetine; pegylated interferon; penicillin G benzathine; penicillin V potassium; pentamidine; pentobarbital; phenytoin; pioglitazone; piroxicam; pneumococcal 23; pravastatin; prednisone; pregabalin; pneumococcal 13 - valent conjugate vaccine; primaquine phosphate; probenecid; prochlorperazine; promethazine; propranolol; protriptyline; pyrazinemide; pyridoxine; pyrimethamine; quetiapine; quiniapril; rabeprazole; raltegravir; ramipril; ranitidine; repaglinide; ribavirin; rifabutin; rifampin; rilpivirine; risedronate; risperidone; ritonavir; rosiglitazone; rosuvastatin; salmeterol; saquinavir; sertraline; simvastatin; sinequan; sitagliptin; somatropin; spironolactone; stavudine; sulfadiazine; sulindac; td; tdap; telmisartan/HCTZ; temazepam; tenofovir; terbutaline; terconazole; testosterone; tiagabine; tipranavir; tolmentin; tramadol; TMP/SMX; trazadone; triamcinolone; triamcinolone 0.1% dental paste; triamterene; trifluoperazine; trimipramine; valacyclovir; valganciclovir; valproate; valsartan; venlafaxine; verapamil; vilazodone; voriconazole; warfarin; zidovudine; ziprasidone; zolpidem.


DISTRICT OF COLUMBIA

202-671-4815 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.dchealth.dc.gov/DC-ADAP

Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acetamenaphine/codeine; acyclovir; adefovir; aerosolized pentamidine; alpha interferon; amitriptyline; amoxicillin/clavulante; aripiprazole; atazanavr; atazanavir/cobicistat; atorvastatin; atovaquone suspension; azithromycin; benztropine; berocca plus vitamins; boceprevir; buprenorphine; buprenorphine/naloxone; bupropion; cidofovir; ciprofloxacin; clarithromycin; clindamycin; clotrimazole; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; dolutegravir; dolutegravir/lamivudine/abacavir; doxorubicin; doxycycline; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfurvirtide; entecavir; erythropoietin alpha; ethambutol; etravirine; ezetimibe; fenofibrate; fentanyl patch; fluconazole; fluoxetine; fosamprenavir; gabapentin; ganciclovir; glipizide; haloperidol; hydrocortisone 2.5%; hydrocortisone valerate 0.2%; ibuprofen; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; levofloxacin; lidocaine patch; linezolid; lopinavir/ritonavir; maraviroc; megestrol; metformin; metformin/glipizide; metformin/pioglitazone; morphine sulfate; nelfinavir; nevirapine; olanazapine; oseltamivir; oxandrolone; peginterferon alfa 2a; peginterferon alfa-2b; pravastatin; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; saquinavir; sertraline; somatropin; stavudine; sulfadiazine; telaprevir; tenofovir; testosterone; tipranavir; TMP/SMX; valacyclovir; valganciclovir; voriconazole; zidovudine; ziprasidone.


FLORIDA

850-245-4422 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.FloridaADAP.org

Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; amantadine; amitriptyline; acyclovir; adefovir; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bupropion; clarithromycin; clotrimazole; cobicistat; daclatasvir; darunavir; darunavir/cobicistat; dapsone; delavirdine; didanosine; diphenoxylate; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dronabinol; duloxetine; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricita-bine; emtricitabine/tenofovir alafenamide;
emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir DF; enfuvirtide; entecavir; epoetin alfa; erythropoietin; escitalopram; ethambutol; etravirine; fenofibrate; filgrastim; fluconazole; fluoxatine; fosamprenavir; gabapentin; gemfibrozil; glipizide; glyburide; hepatitis A/B; hepatitis; hepatitis b; indinavir; imiquimod; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; leucovorin; levaquin; levetiracetam; lopinavir/ritonavir; maraviroc; megestrol; meningococcal oligosaccharide diphtheria CRM197 conjugate; metformin; mirtazapine; nelfinavir; nevirapine; nortriptyline; ombitasvir/paritaprevir/ritonavir; omeprazole; oseltamivir; oxandrolone; pneumococcal; pravastatin; pregabalin; prochlorperazine; pyrimethamine; raltegravir; ribavirin; rifabutin; rilpivirine; rimantadine; risperidone; ritonavir; rosuvastatin; saquinavir; stavudine; sulfadiazine; tenofovir; terconazole; testosterone; tipranavir; TMP/SMX; valacyclovir; valganciclovir; zanamivir; zidovudine; ziprasidone; zoster vaccine recombinant, adjuvanted.


GEORGIA

404-463-0416 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.dph.georgia.gov/adap-program

Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acyclovir; amprenavir; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; clarithromycin; clindamycin; clotrimazole; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; epoetin alpha; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; gabapentin; ganciclovir; hydroxyurea; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; loperamide; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; nystatin; prednisone; primaquine; prochlorperazine; pyrazinamide; pyrimethamine; raltegravir; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; trimethoprim; valacyclovir; valganciclovir; zidovudine.


HAWAII

808-733-9360 (ADAP)
Maximum qualifying income (single): $55,840
Website: www.health.hawaii.gov/harmreduction/hiv-aids/hiv-programs/hiv-medical-management-services

Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acamprosate; acyclovir; albuterol; alendronate; aliretinoin gel; amitriptyline; amlodipine; amphotericin B; amphotericin B liposomal; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; boceprevir; buprenorphine; buprenorphine/naloxone; bupropion; cephalexin; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonidine; clopidogrel; clotrimazole; cobicistat; crofelemer; cyanocobalamin; daclatasvir; dapsone; darunavir; darunavir/cobicistat; daunorubicin; delavirdine; dicloxacillin; didanosine; diphenox-ylate/atropine; disulfiram; divalproex sodium; dolutegravir; doxycycline; dutasteride; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epinephrine autoinjector; epoetin alpha; erythromycin; estradiol- oral, sublingual, transdermal; estradiol cypionate for IM injection; estradiol valerate for IM injection; ethambutol; etravirine; famciclovir; finasteride- 1 MG, 5 MG; fenofibrate; filgrastim; finasteride; fluconazole; flucytosine; fluorouracil; fluoxetine; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gemfibrozil; glecaprevir/pibrentasvir; glyburide; hepatitis A&B vaccines; hexachlorophene 3%; hydrochlorothiazide; hydrocortisone 1% cream; hydroxyurea; imiquimod; indinavir; isoniazid; isosorbide mononitrate; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; leucovorin; levabuterol; levetiracetam; lisinopril; lisinopril/hydrochlorothiazide; loperamide; lopinavir/ritonavir; losartan; maraviroc; medroxyprogesterone acetate, oral; megestrol acetate; metformin; metronidazole; mirtazapine; naloxone; naltrexone; naproxen; nelfinavir; nevirapine; niacin extended-release tablets; norfloxacin; olanzapine; olmesartan; olmesartan/hydrochlorothiazide; ombitasvir/paritaprevir/ritonavir; omeprazole; ondansetron; oseltamivir; quetiapine; paclitaxel; pancrelipase; pantoprazole; paromomycin; paroxetine; peginterferon alpha 2a; peginterferon alfa-2b; pentamidine-aerosolized; pioglitazone; pitavastatin; pneumococcal PSV; posaconazole; pravastatin; prednisone; pregabalin; primaquine; probenecid; prochlorperazine; progesterone, micronized; pyrazinamide; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; risedronate; risperidone; ritonavir; rosiglitazone; rosuvastatin; saquinavir; sertraline; simeprevir; sinecatechins ointment 15%; sofosbuvir; sofosbuvir/velpatasvir/voxilaprevir; spironolactone; stavudine; sulfadiazine; tamsulosin; telaprevir; telbivudine; tenofovir; terazosin; terbinafine; testosterone cypionate; testosterone gel; tetracycline; tipranavir; TMP/SMX; valacyclovir; valganciclovir; vancomycin; varenicline; venlafaxine; viekira pak; warfarin; zanamivir; zidovudine; ziprasidone.


IDAHO

208-334-5612 (ADAP)
Maximum qualifying income (single): $24,280
Website: www.healthandwelfare.idaho.gov/Health/FamilyPlanning,STDHIV/HIVCareandTreatment/tabid/391/Default.aspx

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; azithromycin; bictegravir/emtricitabine/ tenofovir alafenamide fumarate; clarithromycin; crofelemer; dapsone; darunavir; darunavir/cobicistat; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; etravirine; fosamprenavir; indinavir; lamivudine; lamivudine/zidovudine; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine XR; raltegravir; rilpivirine; ritonavir; stavudine; sulfamethoxazole/trimethoprim; tenofovir; tipranavir; valacyclovir; zidovudine.


ILLINOIS

800-825-3518 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.iladap.providecm.net/

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amoxicillin; amphotericin B (I.V. only); amprenavir (solution only); atazanavir; atovaquone; azithromycin; cefixime; cephalexin; chlorhexidine gluconate; cidofovir plus probenecid intravenous; ciprofloxacin; clarithromycin; clindamycin HCL; clindamycin phosphate; clindamycin palmitate/ leucovorin calcium; clotrimazole; cobicistat; daclatasvir; dapsone; darunavir; darunavir/cobicistat; dasabuvir/ ombitasvir/paritaprevir/ritonavir; delavirdine; dicloxacillin sodium; didanosine; diphenoxylate/atropine; dolutegravir; dolutegravir/lamivudine/abacavir; doxycycline hyclate; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; fosamprenavir; gabapentin; ibalizumab-uiyk; imiquimod cream; imodium; indinavir; isoniazid; isoniazid/pyrazinamide/rifampin; itraconazole; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; levofloxacin; lomotil; loperamide; lopinavir/ritonavir; maraviroc; metronidazole; miconazole; nelfinavir; nevirapine; nystatin; ombitasvir/paritaprevir/ritonavir; paromomycin sulfate; penicillin VK; pentamidine isethionate; pravastatin; primaquine phosphate; pyrazinamide; pyridoxine hcl; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; sofosbuvir; sofosbuvir/velpatasvir; stavudine; sulfadiazine; sulfamethoxazole; tenofovir; tesamorelin; testosterone cypionate; testosterone enanthate I.M. only); tipranavir; TMP/SMX; trimethoprim; valacyclovir; valgancyclovir; zidovudine.


INDIANA

866-588-4948 (ADAP)
Maximum qualifying income (single): $36,180
Website: www.in.gov/isdh/17740.htm

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprosate; acetaminophen/hydrocodone; acetaminophen/codeine; acetaminophen/oxycodone; acyclovir; albuterol; alendronate; alprazolam; amitriptyline; amlodipine; amoxicillin; amoxicillin/clavulanate acid; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; betamethasone; bictegravir/emtricitabine; tenofovir alafenamide; buprenorphine+naloxone; beclomethasone; budesonide/formoterol; bupropion; buspirone; carbamezapine; carvedilol; cefixime; ceftriaxone; cephalexin; cetirizine; chlorhexidine-gluconate; ciprofloxacin; citalopram; clarithromycin; clonazepam; clonidine; clopidogrel; clotrimazole; cobicistat; cyclobenzaprine; dapsone; darunavir; darunavir/cobicistat; delavirdine; desipramine; diabetes supplies; didanosine; diphenhydramine; diphenoxylate atropine; disulfiram; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; doxycycline; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; esomeprazole; estradiol; estrogen conjugated; ethambutol; ethinyl estradiol/norgestimate; etravirine; famotidine; fenofibrate; finasteride; fluconazole; flucytosine; fluocinonide; fluoxetine; fluticasone NS; fosamprenavir; gabapentin; gemfibrozil; hydrochlorothiazide; hydroxyzine; ibuprofen; imiquimod; indinavir; insulins; ipratropium/albuterol; isoniazid; isosorbide dinitrate; isosorbide mononitrate; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; leucovorin; levetiracetam; levofloxacin; lisinopril; lithium; loperamide; lopinavir/ritonavir; loratadine; lorazepam; losartan; maraviroc; mary’s magic mouthwash; medroxyprogesterone; metformin; metoprolol; methadone; metronidazole; mirtazapine; morphine sulfate; naltrexone; naproxen; nelfinavir; nevirapine; nicotine patches; nitroglycerine; norethindrone acetate /ethinyl estradiol; nystatin; olanzapine; omega-3-acid ethyl esters; omeprazole; ondansetron; oxycodone; pantoprazole; paroxetine; penicillin G benzathine; pentamidine; phenobarbital; phenytoin; polysaccharide iron complex; pravastatin; prednisone; pregabalin; prochlorperazine; promethazine; pyridoxine; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; risiperidone; ritonavir; ropinirole; saquinavir; sertraline; sitagliptin; spironolactone; stavudine; sulfadiazine; sumatriptan; tamsulosin; temazepam; tenofovir; terbinafine; testosterone; tiotropium; tipranavir; TMP/SMX; tramadol; trazadone; triamcinolone NS; valacyclovir; valganciclovir oral; valproate; varenicline; venlaxafine; voriconazole; warfarin; zidovudine; ziprasidone; zolpidem.


IOWA

Clients apply to ADAP through their case manager so someone wanting ADAP assistance must first engage in case management through one of the ten Ryan White agencies in Iowa. (ADAP)
Maximum qualifying income (single): $48,560
Website: www.idph.iowa.gov/hivstdhep/hiv/support

Iowa has an open formulary with an exclusion list. The ADAP covers all meds unless they fall into a catagory on the exclusion list. Iowa ADAP Formulary Exclusion List-

- Abortifacients – misoprostol, etc.
- Acne medications – tretinoin, benzoyl peroxide, - Accutane, ect.
- Anti-rheumatic injectables – Humira, etc.
- Blood Sera
- Botulinum Toxin
- Compound medications (Prior Authorization required*)
- Cosmetic medications – Botox, creams and ointments, etc.
- Cough suppressants – Robitussin DM, Promethazine w/ codeine
- Durable Medical Equipment
- Erectile Dysfunction medications – Viagra, Cialis, sildenafil
- Fertility medications – Clomid, Menopur, Follistem, etc.
- Hair Removal/Growth medications
- Human Growth Hormone
- Hyaluronic Acid derivatives
- Immune Globulin intravenous
- Infusions
- Injectable muscle relaxants
- Schedule 2 controlled substances – Percocet, Adderall, hydrocodone, methadone, etc.


KANSAS

785-296-6174 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.kdheks.gov/sti_hiv/ryan_white_care.htm

This formulary currently includes all FDA-approved medications for the treatment of HIV infection, including other medications that are utilized for prevention and treatment of secondary infections.


KENTUCKY

866-510-0005 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.chfs.ky.gov/agencies/dph/dehp/hab/Pages/services.aspx

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amoxicillin; amprenavir; atazanavir; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; cephalexin; ciprofloxacin; clarithromycin; clotrimazole; cobicistat; dapsone; darunavir; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtri-citabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; fluconazole; fosamprenavir; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; imiquimod; immodium; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; maraviroc; megestrol; nelfinavir; nevirapine; nystatin; paramomycin; prenatal vitamins; primaquine; promethazine HCL; pyrimethamine; raltegravir; rifabutin; rifampin; rilpivirine; rimactane; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; testosterone; tipranavir; TMP/SMX; trimethoprim; valganciclovir; vitamin D; zidovudine.


LOUISIANA

504-568-7474 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.lahap.org

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amphotericin B; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; cidofovir; clarithromycin; clindamycin; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; foscarnet; ganciclovir; ibalizumab-uiyk; indinavir; isoniazid; itraconazole; lamivudine; leucovorin; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; pentamidine; prednisone; probenecid; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tenofovir/emtricitabine; tipranavir; trimethoprim/sulfamethoxazole; valacyclovir; valganciclovir; zidovudine; zidovudine/lamivudine.


MAINE

207-287-3498 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.maine.gov/dhhs/mecdc/infectious-disease/hiv-std/contacts/adap.shtml

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acyclovir; adefovir dipivoxil; albendazole; amantadine HCL; amikacin; amphotericin B; amprenavir; atazanavir; atovaquone; azithromycin; benzocaine; benzo caine-benzethonium; benzo-caine-ephedrine; benzocaine-phenylephrine; benz-pyril-phenyleph-bismuth subgallate-zinc oxide; butoconazole nitrate; calamine-zinc oxide; camphor-phenol-tannic acid-zinc oxide; caspofungin acetate; cefotaxime sodium; cidofovir; ciprofloxacin; clarithromycin; clindamycin; clotrimazole; cocoa butter-shark liver oil; dapsone; darunavir; delavirdine; dibucaine; didanosine; diperodon HCl; diperodon-pyrilamine-phenylephrine; dolutegravir; doxycycline; dronabinol; econazole; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ephedrine & belladonna; erythromycin; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; gabapentin; ganciclovir; gatifloxacin; hamamelis water-glycerin; hepatitis A vaccine; hepatitis b vaccine; hydrocortisone; indinavir; influenza virus; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lopinavir/ritonavir; maraviroc; measles/mumps & rubella vaccine; methylprednisone; miconazole; minocycline; naftifine; nandrolone decanoate; nandrolone phenpropionate; nelfinavir; nevirapine; nystatin; oseltamivir; oxiconazole; pentamidine; pneumococcal vac polyvalent; prednisone; primaquine; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; rifabutin; rifampin; rifapentine; rilpivirine; rimantadine; ritonavir; saquinavir; sertaconazole; sulconazole; stavudine; sulfadiazine; sulfamethoxazole; tetracycline; tenofovir; testosterone; testosterone cypionate; tioconazole; tipranavir; TMP/SMX; trifluridine; valacyclovir; valganciclovir; varicella-zoster immune globulin; voriconazole; zalcitabine; zidovudine.

List of drugs for HIV-related side-effects is extensive. Please call for complete listing or visit the following link for the complete list: www.maine.gov/dhhs/mecdc/infectious-disease/hiv-std/documents/ADAP_Quarterly_Formulary_Report_1818.pdf.


MARYLAND

410-767-6535 (ADAP)
Maximum qualifying income (single): $60,700
Website: http://pphpa.health.maryland.gov/OIDPCS/CHCS/pages/madap.aspx

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir dipivoxil; albuterol; amantadine; amikacin sulfate; amitriptyline HCL; amlodipine; amoxicillin; amoxicillin/clavulanate potassium; amphotericin-B; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone/proguanil; azathioprine; azithromycin; beclomethasone; belatacept; bictegravir/emtricitabine/tenofovir alafenamide; budesonide; budesonide/formoterol fumarate; buprenorphine sublingual; buprenorphine/naloxone sublingual; bupropion; captopril; carbamazapine; cefpodoxime proxetil; ceftriaxone sodium; cephalexin; chlorothiazide; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonidine; clotrimazole; clotrimazole-betamethasone; cobicistat; crofelemer; cyclosporine; cyclosporine modified; daclatasvir; dapsone; darunavir; darunavir/cobicistat; dasabuvir/ombitasvir/paritaprevir-RTV; daunorubicin citrate liposome; delavirdine; didanosine; diltiazem; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxazosin; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir-grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; enalapril; enfuvirtide; entecavir; epoetin alpha; ergocalciferol; erythromycin; escitalopram oxalate; estradiol cypionate; estradiol transdermal; estradiol valerate; ethambutol; ethinyl estradiol-ethynodiol; ethinyl estradiol-norgestimate; etravirine; everolimus; famciclovir; fenofibrate micronized; fenofibric acid; filgrastim; finasteride; fluconazole; flucytosine; flutamide; fluoxetine; fluphenazine; fluticasone/salmeterol; formoterol; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gemfibrozil; glimepiride; glipizide; glycopyrrolate formeterol fumurate; haloperidol; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; human papillomavirus 9-valent/recomb; hydralazine; hydrochlorothiazide; hydroxizine; hydroxyzine pamoate; imiquimod; indacaterol maleate; indapamide; indinavir; influenza vaccine; insulin detemir; insulin glargine; insulin lispro; insulin NPH; insulin-regular; interferon alpha-2A; interferon alpha 2b; ipratropium/albuterol sulfate; ipratropium bromide; isavuconazonium sulfate; isoniazid; isoniazid-rifampin; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; lancets; lansoprazole; leucovorin; ledipasvir-sofosbuvir; levetiracetam; levofloxacin; levonorgestrel 0.75 mg; lisinopril; lithium carbonate; loperamide; lopinavir/ritonavir; losartan; losartan-hctz; maraviroc; medroxyprogesterone; mefloquine HCl; megestrol acetate; mening vac a,c,y,w-135 dip/pf; metformin HCL; metoclopramide; metoprolol; metronidazole; miconazole; mirtazapine; moxifloxacin HCL; mycophenolate mofetil; mycophenolate sodium; naloxone injection; naloxone nasal spray; nandrolone decanoate; nelfinavir; nevirapine; nifedipine; nitazoxinide; norethindrone; nortriptyline; nystatin; octreotide; ofosbuvir; olanzapine; olanzapine/fluoxetine; olodaterol; ombitasvir-paritaprevir-RTV; omega-3 acid ethyl esters; ondansetron HCL; oseltamivir phosphate; oxandrolone; oxymetholone; paromomycin; paroxetine; peginterferon alfa 2a; peginterferon alfa 2b; penicillin G benzathine; pentamidine; perphenazine; pneumococcal 23 vaccine; pneumococcal conjugate 13-valent; polymyxin B-trimethoprim sulfate; posaconazole; pravastatin; prednisone; primaquine phosphate; prochlorperazine; promethazine HCL; propanolol; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; rimantadine HCL; risperidone; ritonavir; rosuvastatin; salmeterol xinafoate; saquinavir; sertraline;
simeprevir; sirolimus; sitagliptin phosphate; sitagliptin phosphate-metformin HCL; spircinolactone; stavudine; streptomycin sulfate; sulfadiazine; tacrolimus; tacrolimus ext /prolonged; telbivudine; tenofovir; tenofovir alafenamide fumarate; test strips; testosterone; thalidomide; tinidazole; tiotropium; tiotropium bromide-olodaterol; tipranavir; TMP/SMX; trazadone; triamterene; trimethoprim; valacyclovir; valganciclovir; valproic acid; valsartan; valsartan-hctz; venlafaxine; veraparnil; voriconazole; zanamivir; zidovudine.


MASSACHUSETTS

800-228-2714 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.crine.org/hdap/hdap-overview/

MA has an “open formulary” and cover all FDA approved drugs for HIV and related conditions (including HCV). There is a short list of exclusions to the formulary that can be found on the website.


MICHIGAN

888-826-6565 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.michigan.gov/dap

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprosate; acyclovir; acetaminophen/caffeine/butabital; acetaminophen/caffeine/butabital/codeine; albuterol; aldesleukin; alendronate; alprazolam; amitriptyline; amitriptyline; amlodipine; amoxicillin; amoxicillin/clarithromycin/lansoprazole; amoxicllin/clavulanic acid; amphotericin B; amprenavir; aripiprazole; asa/caffeine/butabital; asa/caffeine/butabital/codeine; atazanavir; atazanavir/cobicistat; atenolol; atenolol/chlorthalidone; atorvastatin; atovaquone; azithromycin; baclofen; beclomethasone; benazepril; bictegravir/emtricitabine/tenofovir alafenamide; buprenorphine; buprenorphine/naloxone; buspirone; codeine; codeine/acetaminophen; celecoxib; cephalexin; cetirizine; cetirizine/p-ephedrine; cholestyramine; chlorpromazine; cidofovir; cilostazol; ciprofloxacin; ciprofloxacin/dexamethasone; ciprofloxacin/hc; citalopram; clarithromycin; clindamycin; clopidogrel; clonazepam; clonidine; clotrimazole; clotrimazole/betamethasone; cobicistat; conjugated estrogens tablet/vaginal cream; cyclobenzaprine; dapsone; darunavir; darunavir/cobicistat; delavirdine; dental products; desonide; diabetes supplies; diazepam; diclofenac; diclofenac/misoprostol; dicyclomine; didanosine; diltiazem; diphenhydramine; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; doxycycline; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enalapril/hctz; enfuvirtide; entecavir; epinephrine; epoetin alfa; erythromycin; escitalopram; ethambutol; etravirine; famciclovir; famotidine; felodipine; fenofibrate; fentanyl; filgrastim; fluconazole; fluoxetine; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gemfibrozil; glipizide; glyburide; glyburide/metformin; haloperidol; hctz/triamterene; hepatitis A vaccine; hepatitis B vaccine; hydrochlorothiazide; hydrocodone/acetaminophen; hydrocortisone 2.5% cream; hydromorphone; hydroxyurea; ibuprofen; imiquimod; indinavir; influenza vaccine; insulins; interferon alfa 2b; ipratropium; isoniazid; itraconazole; ketoconazole; lactulose; lamivudine; lamivudine/zidovudine; lansoprazole; leucovorin; levofloxicin; levetiracetam; levothyroxine; lisinopril; lisinopril/hctz; loperamide; lopinavir/ritonavir; loratadine; lorazepam; losartan; losartan/hctz; maraviroc; megestrol; meperidine; mesalamine, 5-ASA; metformin; methadone; methyltestosterone; metoclopramide; metoprolol; metronidazole; minoxidil; mirtazapine; montelukast; morphine; opium tincture; nabumetone; nelfinavir; nevirapine; niacin; nicotine patch/nasal spray/gum; nifedipine XL, ER; nitroglycerin sublingual tab/spray/cap; nizatidine; nystatin; pancrelipase; potassium chloride; ofloxacin; olanzapine; omeprazole; oseltamivir; oxandrolone; oxybutynin; oxycodone; oxycodone/acetaminophen; paromomycin; peginterferon alfa-2a; peginterferon alfa-2b; penicillin; penicillin inj; pentamidine; phenytoin; pioglitazone; pneumonococcal vaccine; podofilox; pravastatin; primaquine; prednisone; prochlorperazine; promethazine; propranolol; pyrazinamide; pyridoxine; pyrimethamine; quinapril; raltegravir; ramipril; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; riman-tadine; risperidone; ritonavir; rosiglitazone; rosigli-
tazone/metformin; saquinavir; silvadene; sodium fluoride; stavudine; sulfadiazine; sumatriptan; tamsulosin; temazepam; tenofovir; terbinafine; testosterone; testostosterone injection/topical; timolol; tipranavir; tizanidine; TMP/SMX; topiramate; tramadol; tramadol/acetaminophen; trimethobenzamide; trimethoprim; valacyclovir; valganciclovir; valsartan; valsartan/hctz; verapamil; voriconazole; zalcitabine; zanamivir; zidovudine; zolpidem.


MINNESOTA

651-431-2414 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.mn.gov/dhs/people-we-serve/adults/health-care/hiv-aids/programs-services/medications.jsp

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir dipivoxil; albendazole; amitriptyline; amoxapine; amoxicillin; amoxicillin/clavulanic acid; amprenavir; androderm; androgel; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atova- quone; azithromycin; bacitracin; bacitracin/polymyxin; boceprevir; buconazole; bupropion; carbamazepine; cefpodoxime; cephadroxil; cephalexin; chlorhexidine gluconate; ciprofloxacin; citalopram; cholestyramine; clarithromycin; clindamycin; clindamycin 1% gel; clotrimazole; cobicistat; dapsone; darafenacin; darunavir; darunavir/cobicistat; delavirdine; desipramine; desmopressin acetate; dicloxacillin; didanosine; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; doxepin; doxycycline; duloxetine; econazole; econazole; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfurvitide; entecavir; epoetin alfa; escitalopram; ethambutol; etravirine; famciclovir; famotidine; fenofibrate; filgrastim; fluconazole; flucytosine; fluoxetine; fluvastatin; fluvoxamine; foscarnet; fosamprenavir; gemfibrozil; gentamicin; imipramine; imiquimod; indinavir; isocarboxazid; isoniazid/vitamin B6; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lansoprazole; leucovorin; levofloxacin; loperamide; lopinavir/ritonavir; lovastatin; maprotiline HCL; maraviroc; megestrol; metoclopramide; metronidazole; miconazole; minocycline; mirtazapine; moxifloxacin; multi vitamins; mupirocin 2% ointment; nelfinavir; nevirapine; niacin; nitrofurantoin; nortriptyline; nystatin; omeprazole; ondansetron; oseltamivir; oxybutynin; pantoprazole; paromomycin; paroxetine; peginterferon alfa-2B; pegylated interferon; penciclovir; penicillin; pentamidine; podofilox; pravastatin; prenatal vitamins; primaquine; prochlorperazine; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; silver sulfadiazine; simeprevir; simvastatin; sofosbuvir; somatropin; stavudine; sulfadiazine; telaprevir; tenofovir; terconazole; tesamorelin; tetracycline; tipranavir; TMP/SMX; trazadone; trimipramine maleate; trospium; valacyclovir; valganciclovir; venlafaxine; voriconazole; warfarin; zanamivir; zidovudne; zolpidem.


MISSISSIPPI

888-343-7373 (ADAP)
Maximum qualifying income (single): $36,140
Website: www.msdh.ms.gov/

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amoxicillin; amitriptyline HCL; atazanavir; atorvastatin; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; chlorihexidine gluconate; citalopram; clarithromycin; clindamycin; crofelemer; dapsone; darunavir; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; fluconazole; fosamprenavir; gabapentin; ibalizumab-uiyk; indinavir; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; maraviroc; metronidazole; nelfinavir; nevirapine; niacin; oxandrolone; peginterferon alfa 2a; pentamidine; pyrazinamide; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; sertraline; stavudine; sulfadiazine; tenofovir; tesamorelin; tipranavir; TMP/SMX; valacyclovir; valganciclovir; zidovudine.


MISSOURI

573-751-6439 (ADAP)
Maximum qualifying income (single): $36,420
Website: www.health.mo.gov/living/healthcondiseases/communicable/hivaids/casemgmt.php

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acetaminophen; acyclovir; adefovir; albendazole; albuterol; alprazolam; amitriptyline; amlodipine; amoxicillin with or without clavulanate; amprenavir; aspirin; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; busesonide and formaterol; buspirone; carbamazepine; carvidilol; cephalexin; chlordiazepoxide; chlorhexidine; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonazepam; clotrimazole; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; diabetic supplies; diazepam; didanosine; divalprox; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; erythromycin; escitalopram; esomeprazole; eszopiclone; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; flucytosine; fluoxetine; fluticasone; fluticasone and salmeterol; fluvoxamine; folinic acid; fosamprenavir; gabapentin; ganciclovir; glipizide; glyburide; hepatitits A vaccine; hepatitis B vaccine; hydrochlorothiazide; hydrocodone; ibuprofen; imipramine; imiquimod; indinavir; insulin; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; lamotrigine; levetiracetam; levofloxacin; levothyroxine; lisinopril; lithium; lopinavir/ritonavir; lorazepam; maraviroc; metformin; methylphenidate; metoprolol; metronidazole; miconazole; mirtazapine; moxifloxican; nefazodone; nelfinavir; nevirapine; nortriptyline; nystatin; olanzapine; omeprazole; oseltamivir; oxycodone combinations; paliperidone; paroxetine; penicillin; pentamidine; phenytoin; pioglitazone; podophyllum; pravastatin; prednisone; pregabalin; prenatal vitamins; primaquine; primidone; prixidone; pyrazinamide; quetiapine; raltegravir; ramelteon; ramipril; ranitidine; resperidone; rosuvastatin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; sertraline; sodium fluoride; stavudine; sucralfate; telbivudine; temazepam; tenofovir; tetracycline; tiotropium; tipranavir; TMP/SMX; trazadone; trifluridine; valacyclovir; valganciclovir; valproic acid; venlafaxine; voriconazole; zalcitabine; zanamivir; zidovudine; ziprasidone; zolpidem.


MONTANA

406-444-4744 (ADAP)
Maximum qualifying income (single): $51,858
Waiting List: No
Website: www.dphhs.mt.gov/publichealth/hivstd

Abacavir; abacavir/dolutegravir/lamivudine; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; aldera cream; amantadine; amitriptyline; amoxicillin; amphotericin B; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; buspirone; carbamazepine; caspofungin; chlorpromazine; ciprofloxacin; citalopram; clarithromycin; clindamycin; clomipramine; clotrimazole tablets; clozapine; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; erythropoietin alfa; escitalopram oxalate; ethambutol; etravirine; ezetimibe; fenofibrate; fenofibric acid; filgrastim; fluconazole; fluoxetine; fluphenazine; folinic acid; fosamprenavir; foscarnet; gabapentin; gemfibrozil; haloperidol; hydroxyzine; ibalizumab-uiyk; imipramine; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; lithium; loperamide; lopinavir/ritonavir; maraviroc; megestrol acetate; mirtazapine; nelfinavir; nevirapine; nortriptyline; nystatin; olanzapine; omega-3-acid ethyl esters; ondansetron; oseltamivir; oxcarbazepine; paroxetine; pentamidine; perphenazine; pravastatin; pregabalin; pyrazinamide; pyrimethamine; quetiapine; raltegravir; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosuvastatin; saquinavir; sertraline; sodium divalproex; sertraline; sodium divalproex; stavudine; sulfadiazine; tenofovir; testosterone; thioridazine; thiothixene; tiagabine; tipranavir; TMP/SMX; topiramate; trazadone; trifluoperazine; valacyclovir; valgancyclovir; valproic acid; varenicline; venlafaxine; vilazodone; voriconazole; zanamivir; zidovudine; ziprasidone.


NEBRASKA

402-471-2101 (ADAP)
Maximum qualifying income (single): $24,280
Website: www.dhhs.ne.gov/publichealth/Pages/dpc_ryan_white.aspx

The Nebraska Ryan White AIDS Drug Assistance Program (ADAP) now enjoys an open formulary for both Copay and Standard (non- insured) ADAP Members. This is subject to change based on funding levels and ADAP does not cover the following:

- Prescription Pain Control Medications
- Any Schedule II Controlled Substances
- Narcotics
- ADHD
- Cosmetic Agents
- Cough Suppressants
- Erectile Dysfunction Agents
- Fertility Agents


NEVADA

775-684-4247 (ADAP)
Maximum qualifying income (single): $48,560

Website: www.dpbh.nv.gov/Programs/HIV-Ryan/Ryan_White_Part_B_-_Home/

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amlodipine; amoxicillin/clavulanate; atazanavir; atenolol; atorvastatin calcium; atovaquone; azithromycin; cefpodoxime; ciprofloxacin; clarithromycin; clindamycin; clotrimazole; dapsone; darunavir; darunavir/cobicistat; darbopoeiten; delavirdine; didanosine; diphenoxylate/atropine; diprolene ointment and cream; divalproex sodium; dolutegravir; dolutegravir/lamivudine/ abacavir; dolutegravir/rilprivirine; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emticitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; erythropoetin; ethambutol; etravirine; fenofibrate; fluconazole; fosamprenavir; gabapentin; GCSF; gemfibrozil; glyburide; hydrochlorothiazide; ibuprofen; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lisinopril; loperamide; lopinavir/ritonavir; losartan; lovaza; maraviroc; megestrol; metformin; moxifloxacin; naprosyn; nelfinavir; nevirapine; niaspan; nitazoxanide; nystatin; ondansetron-only after compazine; pancreatic enzymes; paromomycin; phenytoin; pioglitazone; posaconazole; primaquine; prochlorperazine; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritonavir; saquinavir; scopalamine patch; stavudine; sulfadiazine; tenofovir; testosterone; tipranavir; TMP/SMX; trazadone; triamcinolone ointment and cream; valganciclovir; zidovudine.


NEW HAMPSHIRE

603-271-4502 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.dhhs.nh.gov/dphs/bchs/std/care.htm

The NH Care Program formulary covers all FDA approved antiretroviral and opportunistic infection-related medications with some exclusions. The NH CARE Program follows the Medicaid Preferred Drug List (PDL) and has a list of excluded items.

The following exclusions apply, but are not limited to:

- Therapeutic Class Name
- Antirheumatic Injectibles
- Compound Drugs
- Botulinum Toxin Compounds and Cosmetics
- Erectile Dysfunction Drugs
- Fertility Drugs
- Hair Growth Stimulants
- Herbal Medications
- Hyaluronic Acid Derivatives
- Immune Globulin Intravenous
- Injectable Muscle Relaxants
- Mifepristone
- Over the Counter Drugs *
- Recombinant Human Growth Hormone
* Exceptions apply


NEW JERSEY

877-613-4533 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.nj.gov/health/hivstdtb/hiv-aids/medications.shtml

The program covers a wide range of FDA-approved medications for treating individuals with HIV and AIDS. Your doctor or clinic will tell you which of the approved drugs are appropriate for you.


NEW MEXICO

505-476-3628 (ADAP)
Maximum qualifying income (single): $48,560
Website: http://www.nmhealth.org/about/phd/idb/hats/

New Mexico’s AIDS Drug Assistance Program (ADAP) strives to ensure that persons living with HIV (PLWH) across the state have access to life-saving HIV-related medications. While the emphasis is on HIV anti-retroviral therapy (ART) drugs, other FDA-approved medications are covered as well.

Effective July 1, 2018, the New Mexico ADAP no longer has a specific list of medications that are included in a standardized “formulary”. Instead, the state will use an Enhanced Formulary model. Under this model, any FDA-approved medications could be considered for coverage depending on the patient’s needs, prescriber’s recommendations, and specific health insurance coverage. See link for more information: www.nmhealth.org/publication/view/general/4529/


NEW YORK

800-542-2437 (ADAP)
Maximum qualifying income (single): $52,809
Website: www.health.ny.gov/diseases/aids/general/resources/adap/eligibility.htm

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acebutolol; acetohexamide; albuterol; albuterol-ipratropium; alclometasone; acetylcholine; acrivastine/pseudoephedrine; acyclovir; adefovir; albendazole; alitretinoin; alprazolam; amcinonide; amiloride; amitriptyline; amlexanox; amlodipine; amoxicillin; amoxicillin-clavulanate; ampicillin; apraclonidine; amprenavir; aminosalicyclic acid; amphotericin B; amylase-lipase-protease; aripiprazole; atazanavir; atazanavir/cobicistat; atropine-diphenoxylate; azithromycin; aztreonam; atenolol; atorvastatin; atovaquone; atropine; azatadine; bacitracin; beclomethasone; benazepril; bendroflumethiazide; benztropine; betamethasone; betaxolol; bictegravir/emtricitabine/tenofovir alafenamide; bisoprolol; bitolterol; bleomycin; brimonidine; brinzolamide; brompheniramine w/wo combinations; budesonide; bumetanide; buprenorphine; bupropion; buspirone; butabarbital; candesartan; capreomycin; captopril; carbachol; carbamazepine; carbinoxamine; carteolol; carvedilol; caspofungin; cefaclor; cefadroxil; cefazolin; cefixime; cefoxitin; cefpodoxime; cefprozil; ceftazidime; ceftriaxone; cefuroxime; cephalexin; cephradine; chloral hydrate; chloramphenicol; chlordiazepoxide w/wo clidinium; chlorhexidine gluconate; chlorothiazide; chlorpheniramine w/wo/ combinations; chlorpropamide; chlorthalidone; chlorpromazine; cholestyramine; cidofovir; cimetidine; ciprofloxacin; citalopram; clarithromycin; clemastine; clindamycin; clobetasol; clocortolone; clomipramine; clonazepam; clonidine; clopidogrel; clorazepate; clotrimazole; cloxacillin; clozapine; cobicistat; colestipol; cromolyn; cyclopentolate; cyclopentolate-phenylephrine; cyclophosphamide; cycloserine; cyproheptadine; cytarabine; dapsone; darunavir; darunavir/cobicistat; desonide; desoximetasone; daunorubicin liposomal; delavirdine; desipramine; dexamethasone; dexbrompheniramine/pseudoephedrine; dexchlorpheniramine; dextroamphetamine; diabetes supplies; diazepam; dicloxacillin; didanosine; diflorasone; digoxin; diltiazem; diphenhydramine; dipivefrin; divalproex sodium; dolasetron; dolutegravir; dolutegravir/abacavir/lamivudine; dolutegravir/rilpivirine; dorzolamide; dorzolamide w/timolol; dorzolamide; doxazosin; doxepin; doxorubicin; doxycycline; dronabinol; duloxetine; dyphylline; econazole; ecothiopate; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenfovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; enoxaparin; entecavir; epoetin alfa; erythromycin; escitalopram; esomeprazole; estrogen; estrogens-progestins; ethambutol; ethionamide; etoposide; etravirine; ezetimibe; felbamate; felodipine; fenofibrate; filgrastim; fluconazole; flucytosine; flunisolide; fluocinolone; fluoride; fluoxetine; fluphenazine; flurandrenolide; flurazepam; fluticasone; fluvastatin; fluvoxamine; flavoxate; formivirsen; formoterol; fosamprenavir; foscarnet; fosfomycin; fosinopril; furazolidone; furosemide; gabapentin; ganciclovir; gatifloxacin; gemfibrozil; gentamicin; glimepiride; glipizide; glyburide; granisetron; griseofulvin; guanabenz; guanadrel; guanfacine; halazepam; halcinonide; halobetasol; haloperidol; hepatitis A & B vaccines; HPV vaccine; homatropine; hydralazine; hydrochlorothiazide; hydrocortisone w/wo/ combinations; hydroflumethiazide; hydroxyurea; hydroxyzine; ibalizumab-uiyk ibuprofen; imipenem-cilastatin; imipramine; imiquimod; immune globulin Rho; indapamide; indinavir; insulin; interferon alfa; intravenous immune globulin (18 and under); ipratropium; irbesartan; isoniazid; isosorbide; isoxsuprine; isradipine; itraconazole; ivermectin; kanamycin; ketoconazole; ketoprofen; labetalol; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; latanoprost; leucovorin; levetiracetam; levobunolol; levofloxacin; lisinopril; lithium; lomustine; loperamide; lopinavir/ritonavir; loracarbef; lorazepam; losartan; loteprednol; loxapine; maraviroc; magnesium sulfate; medrysone; megestrol; meningococcal vaccine; mesoridazine; metaproterenol; metoclopramide; metformin; methotrexate; methyclothiazide; methyldopa; methylphenidate; metipranol; metolazone; metoprolol; metronidazole; miconazole; miglitol; minocycline; minoxidil; mirtazapine; misoprostol; moexipril; molindone; mometasone; montelukast; moricizine; moxifloxacin; mupirocin; nadolol; naphazoline w/wo combinations; naproxen; nefazodone; nelfinavir; neomycin w/wo/combinations; nevirapine; niacin; nicardipine; nicotine inhaler; nicotine nasal spray; nifedipine; nisoldipine; nitrofurantoin; nitroglycerin; nortriptyline; nystatin; ofloxacin; olanzapine; omega 3 fatty acids; omeprazole; ondansetron; opium; oprelvekin; oseltamivir; oxazepam; oxcarbazepine; oxtriphylline; oxybutynin; paclitaxel; pancrelipase; pantoprazole; papaverine; paromomycin; paroxetine; peginterferon; pemoline; penbutolol; penciclovir; penicillin; pentamidine; pentobarbital; perphenazine; phenir/ppa/phenylt./pyrilamine; phenylephrine-promethazine; phenylprop-pyril-pheniramine; phenyltolox-APAP; phenyltolox/pyril/pheniramine; phenytoin; metipranol; pindolol; pioglitazone; pirbuterol; podofilox; polythiazide; pravastatin; prazosin; prednicarbate; prednisolone; prednisone; pregabalin; primaquine; primidone; probenecid; procainamide; procarbazine; prochlorperazine; progestins; promethazine; propranolol; pyrazinamide; pyrimethamine; quetiapine; quinapril; rabeprazole; raltegravir; ramipril; ranitidine; repaglinide; ribavirin; rifabutin; rifampin w/wo combinations; rifapentine; rilpivirine; rimantadine; rimexolone; risperidone; ritonavir; rosiglitazone; rosuvastatin; salmeterol; saquinavir; sargramostim; secobarbital; sertraline; sotalol; sparfloxacin; spectinomycin; spironolactone; stavudine; streptomycin; sucralfate; sulfadiazine; sulfadoxine/pyrimethamine; sulfasalazine; telmisartan; temazepam; tenofovir; terazosin; terbinafine; terbutaline; terconazole; testosterone; tetracycline; thalidomide; theophylline; tiagabine; ticarcillin-clavulanate; thiethylperazine; thioridazine; thiothixene; timolol; tiotropium; tipranavir; TMP/SMX; tobramycin; tocainide; tolazamide; tolbutamide; tolterodine; topiramate; torsemide; tramadol; trandolapril; trazadone; triamcinolone; triamterene; triazolam; trichlormethiazide; trifluoperazine; trimethobenzamide; trimethoprim; trimipramine; triple sulfa; triprolidine; tropicamide w/wo hydroxyamphetamine; valacyclovir; valganciclovir; valproic acid; valsartan; vancomycin; varenicline; venlafaxine; verapamil; vinblastine; vincristine; voriconazole; warfarin; zafirlukast; zanamivir; zidovudine; zileuton; ziprasidone; zolpidem.


NORTH CAROLINA

877-466-2232 (ADAP)
Maximum qualifying income (single): $36,420
Website: http://www.epi.publichealth.nc.gov/cd/hiv/hmap.html

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir; amikacin; amitriptyline; amlodipine; amoxicillin; amphotericin B; amprenavir; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azithromycin; benazepril; bupropion; carbamazepine; cephalexin; cidofovir; ciprofloxacin; citaolpram; clarithromycin; clindamycin; clonidine; clotrimazole; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; divalproex; dolutegravir; dolutegravir/lamivudine/abacavir; doxepin; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; entecavir; erythropoetin; escitalopram; ethambutol; etravirine; ezetimibe; famciclovir; fenofibrate; fenofibric acid; filgrastim; fluconazole; flucytosine; fluoxetine; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; hydrocholorithiazide; hydroxyurea; imiquimod; indinavir; interferon alfacon-1; interferon alfa-2a; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lansoprazole; leucovorin; levetiracetam; levofloxacin; lisinopril HCTZ; loperamide; lopinavir/ritonavir; lovastatin; maraviroc; megestrol; metformin; metoclopramide; metoprolol; metronidazole; minocycline; mirtazapine; moxifloxacin; nelfinavir; nevirapine; nortriptyline; nystatin; omeprazole; ondansetron; oseltamivir; pancrelipase; paromomycin; paroxetine; peginterferon alfa 2a; peginterferon alfa 2b; penicillin G benzathine; penicillin VK; pentamidine; phenobarbital; phenytoin; pravastatin; prednisone; pregabalin; primaquine; probenecid; prochloroperazine; promethazine; pyrazinamide; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; stavudine; tenofovir; testosterone; tipranavir; TMP/SMX; trazadone; valacyclovir; valganciclovir; varenicline; venlafaxine; verapamil; zidovudine.


NORTH DAKOTA

701-328-2378 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.ndhealth.gov/hiv/RyanWhite/

23-valent pnemococcal; abacavir; abacavir/lamivudine; acetaminophen/codeine; acyclovir; albendazole; albuterol inhaler; amantadine HCL; amitriptyline; amoxicillin; amphotericin; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; calcium acetate; chlor-hexidine; cidofovir; ciprofloxacin; clindamycin; clotrimazole; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; diphenoxylate w/atropine; doxazosin; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/tenofovir DF; erythromycin; erythropoietin; ethambutol; etravirine; famciclovir; fenofibrate; filgrastim; fluconazole; fludrocortisone; fluoxetine; fosamprenavir; foscarnet sodium; gaba-pentin; ganciclovir; haemophilus influenzae B; haloperidol; hepatitis A vaccine; hepatitis B vaccine series; hepatitis A/B vaccine; influenza; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lisinopril; loperamide; lopinavir/ritonavir; lorazepam; maraviroc; megestrol; meningococcal; morphine; nelfinavir; nevirapine; nystatin; olanzapine; ondansetron; oseltamivir; pantoprazole; paromomycin; pentamidine; pneumococcal vaccine; pravastatin; prednisone; prochlorperazine; pyrimethamine; quadrivalent human papillomavirus; raltegravir; ranitidine; rifabutin; rilpivirine; ritonavir; saquinavir; sertraline; sulfadiazine; tdap; tenofovir; tetanus/ diphtheria/pertussis; TMP/SMX; trazadone; valganciclovir; venlafaxine; vitamin; zidovudine.


OHIO

866-777-4775 (ADAP)
Maximum qualifying income (single): $36,420
Website: www.odh.ohio.gov/odhprograms/hastpac/hivcare/Ohio%20ADAP/Ohio%20ADAP.aspx


Abacavir; abacavir/lamivdine; abacavir/lamivudine/zidovudine; acyclovir; albuterol sulfate inhaler; amitriptyline; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; atropine diphenoxylate; azithromycin; bedaquiline; buproprion/budeprion; citalopram; clotrimazole; clotrimazole/betamethazone dipropionate; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafena- mide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; enfuvirtide; epoetin alfa; ethambutol; etravirine; fenofibrate; filgrastim; fluconazole; fluoxetine; fosamprenavir; gabapentin; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; HPV vaccine; imiquimod; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; levetiracetam; loperamide; lopinavir/ritonavir; maraviroc; mirtazapine; nelfinavir; nevirapine; nystatin; paroxetine; penicillin G benzathine; penicillin G procaine; pentamidine; pneumococcal 13-valent conjugate vaccine; pneumococcal pneumonia vaccine; promethazine; pyrimethamine; quetiapine; raltegravir; rifabutin; rifapentine; rilpivirine; ritonavir; ritonavir; rosuvastatin; saquinavir; sertraline; stavudine; sulfadiazine; tenofovir; testosterone; tetanus vaccine; tipranavir; TMP/SMX; trazadone; valacyclovir; valganciclovir; varenicline; venlafaxine; zidovudine.


OKLAHOMA

405-271-4636 (ADAP)
Maximum qualifying income (single): $24,280
Website: www.ok.gov/health/Disease,_Prevention,_Preparedness/HIV_STD_Service/Ryan_White_Programs/index.html

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; azithromycin; cobicistat; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dronabinol; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenfovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; etravirine; fluconazole; fosamprenavir; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; oxandrolone; raltegravir; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; tenofovir; TMP/SMX; valganciclovir; zidovudine.

Other formulary drugs include antibiotics, antihypertensives, diuretics, antidepressants, lipid control, anti-nausea, anti-anxiolytic, anti-psychotic, anti-epileptic and opportunistic infection medications.


OREGON

971-673-0144 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.healthoregon.org/careassist

Additional Information: Oregon essentially has an open formulary. Medications are added as they become FDA approved.

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acebutolol; acyclovir; adefovir dipivoxil; aerosolized pentamidine; alprazolam; amikacin; amitriptyline; amlodipine; amoxicillin; amoxicillin/potassium clavulanate; ampicillin; atenolol; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; benazepril; buprenorphine; bupropion; buspirone; captopril; capreomycin; carvedilol; cefpodoxime; ceftriaxone; cephalexin; chlordiazepoxide; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonazepam; clotrimazole; clotrimazole/betamethasone; cobicistat; cyancobalamin; dapsone; darunavir; darunavir/cobicistat; delavirdine; diabetic supplies; diazepam; dicloxacillin; didanosine; diltiazem; diphtheria/tetanus; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxazosin; doxycycline; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; entecavir; epoetin-alpha; erythromycin; ethambutol; ethionamide; etravirine; felodipine; fentanyl; filgrastim; fluconazole; fluoxetine; flurazepam; folic acid; fomivirsen; fosamprenavir; foscarnet; furosemide; ganciclovir; glimepiride; glipizide; glyburide; haloperidol; hemophilus influenza Type B vaccine; hepatitis A/B vaccine; hepatitis A/hepatitis B vaccine; hepatitis B Immune Globulin; human papillomavirus/HPV; hydralazine; hydrocholorthiazide; hydrocodone/APAP; hydrocodone/ibuprofen; hydroxyzine HCL, pamoate; indinavir; interferon alfa-2a; inteferon alfa-2b; interferon alfacon 1; interferon alfa-N3; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lisinopril; lopinavir/ritonavir; lorazepam; losartan; maraviroc; metformin; metformin/repaglinide; metformin/rosiglitazone; metformin/sitagliptin; methadone; metoprolol; miconazole; mirtazapine; morphine sulfate; moxifloxacin; naproxen; nelfinavir; nevirapine; nifedipine; nystatin; ofloxacin; olanzapine; oseltamivir; oxycodone; oxycodone/APAP; oxycodone/ASA; naproxen; oxazepam; para-aminosalicylic acid; paroxetine; pegylated interferons; penicillin; perphenazine; pioglitazone; pneumococcal vaccine; propranolol; pyrazinamide; pyridoxine; pyrimethamine; quetiapine; quinapril; raltegravir; repaglinide; ribavirin; ribavirin/interferon alfa 2B; rifabutin; rifampin; rifampin/isoniazid; rifapentine; rilpivirine; risperidone; ritonavir; rosiglitazone; saquinavir; sertraline; sitagliptin; spironolactone; stavudine; streptomycin; sulfadiazine; sulfa/pyrimethamine; telbivudine; temazepam; tenofovir; terconazole; tetracycline; thiothixene; tipranavir; trazadone; trimethoprim; TMP/SMX; valacyclovir; valganciclovir; vancomycin oral; varenicline; venlafaxine; verapamil; zanamivir; zidovudine; ziprasidone.


PENNSYLVANIA

800-922-9384 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.health.pa.gov/topics/programs/HIV/Pages/Special-Pharmaceutical-Benefits.aspx

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir/valacyclovir; amikacin; amphotericin B; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bleomycin; capreomycin; cidofovir injection; ciprofloxacin; cobicistat; clarithromycin; clindamycin; clofazimine; clotrimazole; dapsone; darunavir; darunavir/cobicistat; crofelemer; delavirdine; dexamethasone; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxorubicin; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; ethionamide; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; foscarnet; ganciclovir; ibalizumab-uiyk; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; lovaza; maraviroc; megestrol; nelfinavir; nevirapine; nevirapine XR; nystatin; ofloxacin; paromomycin sulfate; pentamidine; prednisone; primaquine phosphate; pyrazinamide; pyrimethamine; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; sulfadoxine/pyrimethamine; tenofovir; terconazole; tipranavir; TMP/SMX; trimetrexate; valganciclovir; vinblastine; vincristine; zidovudine.

List of drugs for HIV-related side-effects is extensive. Please call for complete listing or visit the following link: www.health.pa.gov/topics/Documents/Programs/HIV/SPBP%20Covered%20Drug%20List%20(Effective%2007-01-18).pdf


RHODE ISLAND

401-462-3294 (ADAP)
Maximum qualifying income (single): $60,700
Website: http://www.eohhs.ri.gov/Consumer/Adults/RyanWhiteHIVAIDS.aspx

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amprenavir; atazanavir; atovaquone; azithromycin; ciprofloxacin; citalopram; clarithromycin; clonazepam; dapsone; darunavir; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; atazanavir/cobicistat; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; fentanyl; fluconazole; fluoxetine; fosamprenavir; gabapentin; ganciclovir/oral; hydroxyurea; indinavir; interferon Alfa 2b; isonaizid; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; lorazepam; maraviroc; morphine sulfate; nelfinavir; nevirapine; olanzapine; oseltamivir; oxycodone; paroxetine; pentamidine; peginterferon alfa 2a; peginterferon alfa 2b; primaquine; pyrimethamine; raltegravir; ribavirin; rifabutin; risperidone; ritonavir; saquinavir; sertraline; stavudine; sulfadiazine; sulfamethoxazole/trimethoprim; tenofovir; tipranavir; trazodone; valacyclovir; valganciclovir; zanamivir; zidovudine.


SOUTH CAROLINA

800-856-9954 (ADAP)
Maximum qualifying income (single): $66,770
Website: www.scdhec.gov/Health/DiseasesandConditions/InfectiousDiseases/HIVandSTDs/AIDSDrugAssistancePlan/

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amoxicillin; amoxicillin-clavulanate, oral; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; ciprofloxacin, oral; citalopram; clarithromycin; clindamycin; clotrimazole; clotrimazole/betamethasone cream; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; escitalopram; ethambutol; etravirine; famciclovir; fluconazole; fluoxetine; fosamprenavir; gabapentin; indinavir; itraconazole; ketoconazole tablets, cream; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lopinavir/ritonavir; maraviroc; metronidazole, oral; mirtazapine; moxifloxacin, oral; nelfinavir; nevirapine; nystatin; nystatin/triamcinolone, cream, ointment; ondansetron; oseltamivir; paroxetine; peginterferon-alfa 2a; peginterferon-alfa 2b; pravastatin; prednisone, oral; promethazine; pyrimethamine; raltegravir; ribavirin, oral; rifabutin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; simvastatin; stavudine; sulfadiazine; tesamorelin; tenofovir; tipranavir; TMP/SMX; trazadone; valacyclovir; valganciclovir; venlafaxine; voriconazole; zanamivir; zidovudine.


SOUTH DAKOTA

605-773-3737 (ADAP)
Maximum qualifying income (single): $36,420
Website: http://doh.sd.gov/diseases/infectious/ryanwhite/

23-valent; abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acetaminophen w/codeine; acyclovir; amitriptyline; amprenavir; atazanavir; atovaquone; azithromycin; ciprofloxacin; clarithromycin; clofazamine; clotrimazole; dapsone; darunavir; delavirdine; didanosine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fentanyl; fluconazole; fosamprenavir; gabapentin; indinavir; influenza; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; interferon alfa-2b; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lopinavir/ritonavir; maraviroc; megestrol; morphine w/wo sulphate; nelfinavir; nevirapine; paromomycin sulfate; peg-interferon alfa 2-a; peg-interferon alfa 2-b; pentamidine; phenytoin; pregabalin; prochlorperazine; pyrimethamine; raltegravir; ribavirin/interferon alfa-2b; ribavirin; rifabutin; rilpivirine; ritonavir; saquinavir; stavudine; tenofovir; tipranavir; TMP/SMX; triamcinolone acetoinide cream; valacyclovir; zalcitabine; zidovudine.


TENNESSEE

615-741-7500 (ADAP)
Maximum qualifying income (single): $48,560
Website: http://www.tn.gov/health/health-program-areas/std0/std/ryanwhite.html

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; ceftriaxone; clarithromycin; clindamycin; cosyntropin; dapsone; darunavir; darunavir/cobicistat; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; enfuvirtide; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; ethambutol; etravirine; fluconazole; foscarnet; fosamprenavir; gabapentin; ganciclovir; gemfibrozil; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; leucovorin; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; novolin 70/30; nystatin; quine; ombitasvir/paritaprevir/ritonavir; pioglitazone; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritonavir; saquinavir; sertraline; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; valacyclovir; valganciclovir; vancomycin; venlafaxine; zidovudine.


TEXAS

800-255-1090 (ADAP)
Maximum qualifying income (single): $24,280
Website: www.dshs.texas.gov/hivstd/meds/default.shtm

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; clarithromycin; clindamycin; clotrimaz troche; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fluconazole; fosamprenavir; gynazole; indinavir; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; lopinavir/ritonavir; maraviroc; megestrol acetate; mystatin; nelfinavir; nevirapine; pentamidine; prednisone; primaquine phosphate; raltegravir; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; terconazole; tipranavir; TMP/SMX; valacyclovir; valganciclovir; voriconazole; zidovudine.


UTAH

801-538-6197 (ADAP)
Maximum qualifying income (single): $30,350
Website: www.health.utah.gov/epi/treatment/

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofofvir alafenamide; clarithromycin; clindamycin; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/rilpivirine; dolutegravir/lamivudine/abacavir; efavirenz; efavirenz/tenofovir/emtricitabine; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; emtricitabine; emtricitabine/rilpivirine/tenofovir; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/tenofovir; emtricitabine/tenofovir alafenamide; enfuvirtide; ethambutol; etravirine; fluconazole; fosamprenavir; ibalizumab-uiyk; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; linezolid; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; nystatin; pentamidine inhaled; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; valacyclovir; valgancyclovir; zidovudine; zoster vaccine - recombinant, adjuvanted.


VERMONT

802-951-4005 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.healthvermont.gov/immunizations-infectious-disease/hiv/care

Abacavir; abacavir/lamivudine/zidovudine; acyclovir; albuterol (inhaled); amitriptyline; amphoteracin B; amprenavir; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; buproprion; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clotrimazole; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dideoxycytidine; dolutegravir; dolutegravir/abacavir/lamivudine; dolutegravir/rilpivirine; doxorubicin (liposomal); efavirenz; efavirenz/emtricitabine/tenofovir DF; elivitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; escitalopram; ethambutol; etravirine; ezetimibe; famciclovir; fenofibrate; fentanyl; fluconazole; fluoxetine; fluvastatin; fosamprenavir; foscarnet;gabapentin; GCSF; gemfibrozil; hydroxyurea; ibuprofen; indinavir; itraconazole; ketoconazole; lamivudine; lamivudine/abaca-vir; lamivudine/zidovudine; leucovorin; levoalbuterol; loperamide; lopinavir/ritonavir; lovastatin; maraviroc; megestrol acetate; morphine sulfate; nefazodone; nelfinavir; nevirapine; niacin; nystatin; oseltamivir; paroxetine; pentamidine; polycarbophil; prednisone; primaquine; pravastatin; psyllium; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritinovir; saquinavir; sertraline; simvastatin; stavudine; sulfadiazine; tenofovir; tipranavir; trazadone; trimethoprim; trimethoprim/sulfamethoxazole; valacyclovir; valganciclovir; venlafaxine; zanamivir; zidovudine.


VIRGINIA

855-362-0658 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.vdh.virginia.gov/ADAP

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; aerosolized pentamidine; alendronate sodium; amikacin; amitriptyline; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; buspirone; capreomycin; chlorpromazine; cidofovir; citalopram; clarithromycin; clindamycin; cycloserine; daclatasvir; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; epoetin alpha; escitalopram; esomeprazole; ethambutol; ethionamide; etravirine; ezetimibe; famciclovir; famotidine; fenofibrate; fluconazole; fluoxetine; fosamprenavir; foscarnet; gabapentin; ganciclvir IV; glipizide; gemfibrozil; glipizide/metformin; glyburide; glyburide/metformin; haloperidol; hepatitis A; hepatitis B; hepatitis A/B; hydroxyzine; indinavir; influenza; insulininjectable; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; lansoprazole; ledipasvir/sofosbuvir; leucovorin; levofloxacin; lithium; lopinavir/ritonavir; mara- viroc; megestrol; metformin; meningococcal conjugate vaccine; mirtazapine; nelfinavir; nevirapine; niacin; nortriptyline; olanzapine; omeprazole; pantoprazole; para-aminosalicylic acid; paroxetine; pioglitazone hydrochloride; pneumococcal conjugate; pneumococcal vaccine polyvalent; pravastatin; prednisone; primaquine; prochlorperazine; promethazine; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; ranitidine; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosiglitazone; rosuvastatin; saquinavir; sertraline; sofosbuvir; stavudine; sulfadiazine; tenofovir; tenofovir alafenamide; tetanus/diphtheria; tetanus/diphtheria/pertussis; tipranavir; TMP/SMX; trazadone; trimethoprim; valganciclovir; valproic acid/divalproex sodium; venlafaxine; viekira pak; voriconazole; zidovudine; ziprasidone; zoster vaccine - recombinant, adjuvanted.


WASHINGTON

877-376-9316 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.doh.wa.gov/YouandYourFamily/IllnessandDisease/HIV/ClientServices
Additional Information: WA ADAP has a very robust program that pays for meds, doctor visits, labs, etc. by wrapping around insurance. WA ADAP can purchase insurance for our clients so about 95% of our clients in our ADAP have insurance.

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprostate; acyclovir; adefovir; albendazole; amoxicillin; amoxicillin/potassium clavulante; ampicillin; amprenavir; atazanavir; atazanavir/cobicistat; atovaquone; azrithromycin; bictegravir/emtricitabine/tenofovir alafenamide; boceprevir; buprenorphine/naloxone; carbamazepine; cefpodoxime; ceftriaxone; cephalexin; chlorhexidine gluconate; cidofovir; cimetidine; ciprofloxacin; clarithromycin; clindamycin; clofazimine; clonidine; clotrimazole; clotrimazole/betamethasone; clozapine; cobicistat; crofelemer; daclatasvir; dapsone; darunavir; darunavir/cobicistat; delavirdine; dicloxacillin; dicyclomine; didanosine; diphenoxylate/atropine; diphtheria & tetanus toxoids; diphtheria & tetanus toxoids & pertussis vaccine; disulfuram; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epoetin-alpha; erythromycin; esomeprazole; estrogen; ethambutol; etravirine; famotidine; filgrastim; fluconazole; fomivirsen; fosamprenavir; foscarnet; gabapentin; ganciclovir; hemophilus influenza type B vaccine; hepatitis A vaccine; hepatitis B vac-cine; hepatitis A/B vaccine; hepatitis B immune globulin; hormone replacement therapy/gender transitioning meds; hydroxyurea; hyoscyamine; imiquimod cream; immune globulin IM; influenza virus vaccine, split or whole virus; indinavir; interferon alfa-2a; inteferon alfa-2b; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; leucovorin; levofloxacin; lindane; lithium; loperamide; lopinavir/ritonavir; maraviroc; mediset fills; medroxyprogesterone; megestrol acetate; methylprednisolone; metoclopramide; metronidazole; miconazole; moxifloxacin; mupirocin; naltrexone; naloxone; nandrolone; nelfinavir; nevirapine; nizatidine; nystatin; ofloxacin; olanzapine; ombitasvir/paritaprevir/ritonavir; omeprazole; ondansetron HCL; opium tincture; oseltamivir; oxandrolone; oxcarbazepine; pantoprazole; paromomycin; pegylated interferons; penicillin; peridex; permethrin; phenazopyridine; pneumococcal vaccine; podofilox; pill splitter; prednisolone 1% soln; prednisone; primaquine; prochlorperazine; promethazine; pyrazinamide; pyrimethamine; quetiapine; rabeprazole; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; saquinavir; selenium sulfide; sofosbuvir/velpatasvir; stavudine; sulfadiazine; sulfa/pyrimethamine; telaprevir; tenofovir; terconazole; testosterone products; tetracycline; tipranavir; topiramate; TMP/SMX; trifluridine; trimethoprim; valacyclovir; valganciclovir; valproic acid; vancomycin oral; VZIG; varicella zoster immune globulin; zalcitabine;
zanamivir; zidovudine; ziprasidone.


WEST VIRGINIA

304-232-6822 (ADAP)
Maximum qualifying income (single): $48,560
Website: www.dhhr.wv.gov/oeps/std-hiv-hep/HIV_AIDS/caresupport/Pages/ADAP.aspx


Abacavir; abacavir/lamivudine; abacavir/lami-vudine/zidovudine; acyclovir; adefovir dipivoxil; albuterol sulfate; alprazolam; amitriptyline; aripiprazole; atazanavir; atorvastatin; atovaquone; azithromycin; bupropion; buspirone; citalopram; clarithromycin; clindamycin; clonazepam; clotrimazole; cobicistat; cotrimoxazole; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; diazepam; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; escitalopram; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; fluoxetine; fluticasone; fosamprenavir; foscarnet; gabapentin; ganciclovir; hepatitis A vaccine; hepatitis b vaccine; hepatitis A/B vaccines; indinavir; interferon alphacon 1; inteferon alpha 2 B; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lisinopril; loperamide; lopinavir/ritonavir; maraviroc; metformin; metoprolol; mirtazapine; naproxen; nelfinavir; nevirapine; niacin; nystatin; omeprazole; paroxetine; peginterferon alfa 2 A; peginterferon alfa 2 B; pentamidine; potassium; prednisone; pregabalin; prochlorperazine; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; stavudine; sulfadiazine; telbivudine; temazepam; tenofovir; testosterone; tipranavir; trazadone; valacyclovir; valganciclovir; venlafaxine; zalcitabine; zidovudine; zolpidem.didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir; elvitegravir/tenofovir alafenamide/emtricitabine/cobicistat; emtricitabine; emtricitabine/tenofovir; emtricitabine/rilpivirine/tenofovir alafenamide; enfuvirtide; entecavir; escitalopram; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; fluoxetine; fluticasone; fosamprenavir; foscarnet; gabapentin; ganciclovir; hepatitis A vaccine; hepatitis b vaccine; hepatitis A/B vaccines; indinavir; interferon alphacon 1; inteferon alpha 2 B; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lisinopril; loperamide; lopinavir/ritonavir; maraviroc; metformin; metoprolol; mirtazapine; naproxen; nelfinavir; nevirapine; niacin; nystatin; omeprazole; paroxetine; peginterferon alfa 2 A; peginterferon alfa 2 B; pentamidine; potassium; prednisone; pregabalin; prochlorperazine; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; stavudine; sulfadiazine; telbivudine; temazepam; tenofovir; testosterone; tipranavir; trazadone; valacyclovir; valganciclovir; venlafaxine; zalcitabine; zidovudine; zolpidem.


WISCONSIN

800-991-5532 (ADAP)
Maximum qualifying income (single): $36,420
Website: www.dhs.wisconsin.gov/aids-hiv/adap.htm

Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amphotericin B; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; cidofovir; clarithromycin; clindamycin; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; indinavir; interferon alpha-2b; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; loperamide; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; niacin; oseltamivir; pegylated interferon alfa-2a; pegylated interferon alfa-2b; pentamidine; pravastatin; prochlorperazine; pyrimethamine; raltegravir; ribavirin; rifabutin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; valacyclovir; valganciclovir; zanamivir; zidovudine.


WYOMING

307-777-5856 (ADAP)
Maximum qualifying income (single): $60,700
Website: www.health.wyo.gov/publichealth/communicable-disease-unit/hivaids/

Wyoming has an open formulary.


Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!