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CHCS : madap

MADAP

The Maryland AIDS Drug Assistance Program (MADAP) ensures that people living with HIV/AIDS in Maryland have access to the medication they need to stay healthy. MADAP is a statewide program and is funded primarily through the Ryan White CARE Act . MADAP pays for medications for eligible clients with no insurance and helps clients with insurance by paying for eligible co-pay and deductible costs so they can get their medication. The list of medicines covered by MADAP (the MADAP formulary) includes a wide range of medications used to treat HIV infection, opportunistic infections, and complications of HIV infection or related conditions, including all anti-retroviral therapies approved by the U.S. Food and Drug Administration.
 
The Prevention and Health Promotion Admin (PHPA) administers MADAP, which currently serves on average 5,900 clients each month. Clients approved for MADAP must re-apply for the program annually, and also confirm continued eligibility at 6 months. See the MADAP Semiannual Verification Notice (SVN). Clients enrolled in MADAP can use MADAP to receive their medications at any of the approximately 1,636 pharmacies that accept Maryland Medical Assistance (Medicaid).
     
    To qualify for MADAP services, a person must meet the following criteria:
    • Be diagnosed as having HIV;
    • Qualify financially (anticipated gross annual household income must be at or below 500 percent of the current federal poverty level for the size of the legal household);
    • Be a resident of Maryland;
    • Not be eligible for Maryland Medical Assistance (Medicaid);
    • Submit a complete MADAP application  with required documentation.
 
All complete MADAP applications are reviewed and processed by MADAP staff to determine eligibility. Eligibility determinations for complete applications are made within 10 business days of receipt. If a client needs medications immediately, MADAP has 2 programs for short-term assistance. See TAP/Urgent MADAP Quick Reference Guide on Provider Resources page (top right).
 
Pharmacies requiring information on claims processing can learn more at MADAP's pharmacy benefit manager website.
 
MADAP requires prior authorization for certain medications. Prescribing Providers can use one of the following forms to request Prior Authorization for: 
 
For more information on the MADAP program, please call 410-767-6535 or 1-800-205-6308 between 8:30 AM and 4:30 PM (EST) Monday through Friday.
 

Provider Resources

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