People on Medicaid receive free or low-cost medical care. MediCal imposes a limit of 6 prescription drugs per person. This conflicts with federal treatment guidelines that recommend early combination therapy to slow disease progression and reduce immune system damage. State ADAPs reimburse the cost of anti-HIV drugs and drugs for opportunistic infections. Each state has a list of covered drugs called a formulary.
Formularies vary from state to state.
Some states put less money into their ADAPs and periodically run out of money, causing them to stop new enrollments, institute drug lotteries or remove drugs from their formularies. California has one of the most comprehensive ADAPs. It places no limits on number of drugs or people enrolled. In San Francisco, city health clinics and some hospitals serve as enrollment sites. In California, promising drugs are usually added to ADAP soon after they are approved.