Ryan White CARE and HOPWA Services

The Illinois Ryan White Part B Program is authorized under the Ryan White CARE Act and is administered by the Illinois Department of Public Health (IDPH). The purpose of this program is to provide HIV positive individuals who reside in Illinois and who are low-income, uninsured, or underinsured with access to a wide variety of core and supportive services. Below are some of the services that are offered through this program to those who qualify. There are 3 units that operate under the Illinois Ryan White Part B Program:

  • AIDS Drug Assistance Program (ADAP-Medication Assistance) - Medication Assistance services are designed to provide assistance with and access to HIV/AIDS medications that are on the approved Ryan White Part B Formulary list.
  • Continuation of Health Insurance Coverage (CHIC-Premium Assistance) - Premium assistance services are designed to assist individuals with payment of their health insurance premiums up to $750 per month for approved plans by the Ryan White Part B Program.
  • Care Services - Illinois HIV Care Connect is an extensive, statewide network of medical case management, healthcare and support services for people living with HIV. Care services also include utility, short-term rent and mortgage assistance using Housing Opportunities for Persons with HIV/AIDS (HOPWA) funding received from the Department of Housing and Urban Development (HUD).

  
Eligibility Requirements (all services):
 
To be eligible for the any of the services available from the program, individuals must meet all of the following requirements:

  • Diagnosed with HIV or AIDS and supply CD4 and Viral Load laboratory results not older than 6 months prior to enrollment
  • Currently live in Illinois and have a legal home address (domicile) in Illinois
  • Verification of Third Party Payer Sources, such as Medicaid, Medicare, or other commercial/employer based insurance
  • Have income not exceeding 500 percent of the federal poverty level. To view the current income levels for 500% federal poverty level see PUBLICATIONS in the right-hand column and click on Annual and Monthly Poverty Level Guidelines.
    • Please note that to be eligible for HOPWA funded services income must not exceed 80 percent the Annual Median Income for the area in which the individual resides.

All applicants approved for services must re-apply every 6 months in order to continue to receive services.

If you have questions regarding your eligibility status for any of the available services, please call our HOTLINE at 800-825-3518.
 

ADAP - Medication Assistance Program

Medication Assistance services are designed to provide assistance with and access to HIV/AIDS medications that are on the approved formulary list which include all anti-retroviral therapies approved by the U.S. Food and Drug Administration.
 
Clients have a benefit cap of $2,000 per month, except for 2 drugs in Category V. This benefit is sufficient to support triple and quadruple combination therapies. These drug combinations have been successful in treating persons with HIV infection, including opportunistic infections frequently associated with HIV; have resulted in drug treatment adherence; and have helped to dramatically prolong the lives of people living with HIV.
 
ADAP – Medication Assistance Formulary and Prescribing Guidelines
 
For a list of the current Formulary and Prescribing Guidelines, see PUBLICATIONS in the right-hand column.
 
According to ADAP-Medication Assistance Prescribing Guidelines certain medications require prior authorization by the program. Please use one of the following forms to request Prior Authorization for initiation (not continuation) of therapy for: enfuvirtide (Fuzeon), valganciclovir hydrochloride (Valcyte), and/or atovaquone (Mepron) medications. To learn more, see Publications in the right-hand column.
 
To apply for services through ADAP-Medication Assistance, see RESOURCES in right-hand column.
 
ADAP-Medication Assistance Contract Pharmacy Incident Reporting Form
 
If you are a prescriber or a client receiving ADAP-Medication Assistance and are experiencing concerns with program’s contracted dispensing pharmacy, please complete the Incident Form. This form is utilized by the program to correspond with the contracted pharmacy on concerns/issues providers may be experiencing.
 
To access an Illinois Medication Assistance Program Incident Form, see FORMS in the right-hand column. You can fax the completed document to the MAP office at 217-785-8013 or mail to:

Illinois Medication Assistance Program
525 W. Jefferson Street, 1st Floor
Springfield, IL 62761
 
If you have questions regarding your eligibility status, please call our HOTLINE at 800-825-3518.
 

CHIC – Premium Assistance Program

The Illinois Department of Public Health offers a health insurance premium payment program to assist people with HIV/AIDS who may have had to leave their employment due to illness and have elected to receive health insurance coverage through COBRA, Illinois Marketplace Insurance Plans, Medicare Part D, Medicare Supplemental Plan, or another commercial group health insurance plan. This special program, which may include a spouse and children on a family health insurance plan, pays a monthly health insurance premium of up to $750.
 
Individuals must meet all of the following requirements:

  • Diagnosed with HIV or AIDS and supply CD4 and Viral Load laboratory results not older than 6 months prior to enrollment
  • Currently live in Illinois and have a legal home address (domicile) in Illinois
  • Have COBRA, Illinois Marketplace Plan, Medicare Part D, Medicare Supplemental Plan, or other commercial or employer health insurance coverage that is not payroll-deducted
  • Have income not exceeding 500 percent of the federal poverty level. To view the current income levels for 500% federal poverty level, see PUBLICATIONS in the right-hand column

All applicants approved for services must re-apply every 6 months in order to continue to receive services.
 
To apply for CHIC-Premium Assistance services, see RESOURCES in the right-hand column.  
 
If you have questions regarding your eligibility status, please call our HOTLINE at 800-825-3518.
 

CARE Services

Through a network of eight regional offices supported by federal Ryan White Part B and Housing Opportunities for People Living with AIDS (HOPWA) grants, Illinois HIV Care Connect provides confidential medical case management services at no charge to HIV+ individuals. In addition, individuals may qualify for other services, depending on eligibility requirements such as their income and insurance status, including:

  • Outpatient/ambulatory healthcare
  • Mental healthcare
  • Oral healthcare
  • Medical nutritional therapy
  • Substance abuse services (outpatient)
  • Food bank
  • Legal assistance
  • Medical transportation
  • Psychosocial support
  • Utility and short-term rent assistance

 
Not all of the above services may be available, and the nature of services may vary, by regional office.  Please contact the regional project director for a referral to a case manager who will verify an individual’s eligibility and discuss available services.
 
Care Providers
 
You may choose to remain the primary care provider for an HIV+ individual referred to Illinois HIV Care Connect. Visit the Midwest AIDS Training and Education Center (MATEC) to learn about free training programs specifically designed to help primary care providers build HIV treatment skills. Through MATEC, you can also learn how to access free clinical consultation services to assist with managing the treatment needs of HIV+ patients.
 
If you are interested in providing services through Illinois HIV Care Connect, contact the project director in your region, see RESOURCES in the right-hand column.  
 
To see the Care Connect Regional Map, see RESOURCES in the right-hand column and click on Illinois HIV Care Connect.
 
To apply for CARE services, see RESOURCES in the right-hand column.

How to Coordinate ADAP and CHIC Coverage With the Affordable Care Act

If you are currently enrolled or are interested in enrolling in ADAP-Medication Assistance or the CHIC-Premium Assistance, you may need to coordinate this coverage with an insurance plan available through the Affordable Care Act marketplace. To learn more, see RESOURCES in the right-hand column and click on Get Covered Illinois.   

There are certain insurance plans that qualify for use with these services. See PUBLICATIONS in the right-hand column and click the link below pertaining to your current coverage for additional information and instructions about what you are required to do.