To be eligible, you must:
- be an NC resident; have HIV;
- have a gross family income at or below 300% FPL;
- not have any third party-coverage; and
- have at least one prescription for any medication on the ADAP formulary.
SPAP is the program within ADAP for clients who have Medicare Part D coverage. Clients on SPAP pay their Medicare Part D premiums and SPAP pays their out of pocket costs for all medications on the ADAP formulary (copayments and all payments in the ‘donut hole’). When a client on SPAP fills a prescription for a medication on the ADAP formulary, the pharmacy will bill their Medicare Part D plan as the primary payer and ADAP as the secondary payer. The client will not incur any expenses for these
dispenses. All ADAP clients who are eligible for Medicare Part D must enroll in a Medicare Part D plan and pay the plan premiums.
There is no cost to individuals on APP or SPAP for medications on the formulary. All clients are responsible for the cost of medications that are not on the formulary. Clients who are eligible for Medicare Part D are required to enroll in a Part D plan and are
responsible for plan premiums.