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About Your Prescriptions

We can enroll you...

 

The Andrew Escajeda Clinic is an official enrollment site for ADAP services.

 

ADAP is a state prescription drug assistance program

funded by Ryan White CARE legislation and state funds.

 

 

Click here to visit the official ADAP website

 

 

 

Eligibility Requirements

You may be eligible for California ADAP services if:

  • You are a resident of the State of California.

  • You are at least 18 years of age.

  • You have an HIV diagnosis (ADAP will only process prescriptions written by a licensed California physician).

  • You have a Federal Adjusted Gross Income not more than $50,000 ( See Levels of Coverage for more information).

  • You have limited or no prescription drug benefit from another source

Under certain circumstances, ADAP may be able to provide assistance in meeting your private insurance co-payment or insurance deductible obligations for medications which are on the ADAP formulary (list of covered drugs).

You may be required to apply for Medi-Cal as part of your ADAP application process. Under some circumstances ADAP can assist you in meeting your Medi-Cal Share of Cost obligation for ADAP covered medications.

 

Click here for a list of ADAP friendly pharmacies in Pasadena

 

 

 

ADAP Formulary

The ADAP Formulary consists of 151 FDA approved drugs. The State of California Medical Advisory Committee and the State Offices of AIDS (The State OA) regularly consider the addition of new drugs to the ADAP formulary including newly FDA approved drugs. To view or print the ADAP formulary, click the view/print formulary alphabetically (by generic name) or by drug class buttons below.

 

 

Click here for alphabetical list of ADAP drug coverages

 

 

 

Program Dispensing Policy

  1. Drugs marked with "•" are to be dispensed with a minimum 30 day supply. Exceptions will require prior authorization.

  2. Drugs marked with "*" Code 1 are restricted by a specific diagnosis, dose form or circumstances of the client. Prior authorization may be required and granted only when Code 1 requirements are met.

  3. Drugs marked with "^" require prior authorization, PMDC will request additional information (client and drug specific) before considering the authorization.

  4. Most drugs are to be dispensed with a maximum 30 day supply. Exceptions will require prior authorization.

  5. Prior authorization is required for DEA class II and III drugs when the quantity exceeds 100 units.

Note: There may be some SPECIFIC DOSAGE FORMS of products on this fomulary that may NOT BE COVERED OR REQUIRE PRIOR AUTHORIZATION. Pharmacies can verify drug coverage by dialing the toll free PMDC Systems' number listed below and selecting the Electronic Verification option. The pharmacy will need their NABP# and the drug's 11-digit national drug code (NDC) PMDC SYSTEMS 1-888-311-PMDC (7632)

 

 

Explore our website or call (626) 744-6140

for additional information.