If you meet the ADAP eligibility criteria, can get the money together for the first month's premium, and your policy is cost-effective, APIC will pay the premiums starting with month two and continuing indefinitely. When you apply for APIC, you have to attach a photocopy of your policy. To determine whether the insurance is cost-effective, the staff will look it over to make sure that it covers the types of services that ADAP covers. With the large numbers of ADAP enrollees on combination medications in New York State, it's cheaper in the long run for ADAP to pay for the insurance coverage this way than it is to pay directly for the drugs. Yes, there are.
Some individual policies have no prescription drug coverage.
Some policies have no or little coverage for care that you get from a doctor who is not in the network. If the doctor isn't in the network, the policy sometimes won't provide any coverage for prescriptions written by that physician. These are all examples of policies with holes or gaps that would cause you to turn to the ADAP program, regardless of your coverage. If the cost of your deductibles and co-payments is so high that it will keep you from using your health insurance to get healthcare, the program will consider enrolling you in ADAP or ADAP Plus. You would assign your insurance benefits to the program and use your ADAP card to get your drugs and healthcare.