Equal Access To Healthcare Program

PRC is pleased to present the Equal Access to Healthcare Program’s third annual report.

Along with showcasing program outcomes and successes, this annual report marks our program expansions, as well as updates from AIDS Emergency Fund, Getting to Zero, and the Frontline Organizing Group (FOG).

Our annual report also highlights the critical impact the Affordable Care Act (ACA) has had for our clients. Notably, 71 percent of PRC clients were able to access health insurance after the ACA was enacted, whereas only 25 percent were insured prior to the ACA. Additionally, the report features a helpful glossary of terms useful for anyone interacting with healthcare insurers. Please use this information both to navigate our report and to assist you in keeping your health coverage up to date.

We hope this report serves as a helpful tool to consumers and providers alike in our community!

ADAP/OAHIPP Update (Effective March 1, 2017)

As of Wednesday, March 1, the California Department of Public Heath (CDPH) has terminated its contract with A.J. Boggs for AIDS Drugs Assistance Program (ADAP) administration.

The termination of A.J. Boggs does not require any action from ADAP clients.

  • CDPH now directly provides
    • ADAP eligibility and enrollment services and
    • the Part D Premium Payment Program
  • Magellan Rx will continue to administer pharmacy benefits. Current pharmacies will not change.
    • Existing clients can call Magellan 24 hours a day, 7 days a week at (800) 424-5906 with questions or issues related to medication access at the pharmacy.
  • Pool Administrators, Inc. (PAI) will administer:
    • Medical Out of Pocket Claims and
    • OA-HIPP.

TIPS FOR RESOLVING PHARMACY ISSUES

  • Contact your ADAP Enrollment Worker to support problem resolution
  • Ask the pharmacist to call Magellan Rx Client Services regarding pharmacy network or benefits questions at 1-800-424-5906
  • Call CA Office of Aids ADAP Call Center & Data Processing Unit with any questions at 1-844-421-7050

IMPORTANT PHONE NUMBERS

  • CA Office of AIDS ADAP Call Center & Data Process Unit 1-844-421-7050
  • Magellan Rx 1-800-424-5906
  • Pool Administrators, Inc (PAI) Fax 860-560-8225

For questions or help, please contact your ADAP enrollment worker or Positive Resource Center at 415-777-0333.

PRC is now an ADAP and OA-HIPP Enrollment Site

Positive Resource Center now offers enrollment and recertification assistance for the AIDS Drug Assistance Program (ADAP) and the Office of AIDS Health Insurance Premium Payment program (OA-HIPP).

ADAP and OA-HIPP provide assistance with paying prescription co-pays and health insurance premium payments. HIV-positive individuals making less than $60,300/year may be eligible for assistance. Couples and families may also be eligible, as income rules depend on household income and size.

HIV-positive San Francisco residents may access services by calling 415-777-0333.

Equal Access to Healthcare Program

Positive Resource Center’s EAHP aims to identify and overcome barriers to healthcare access for San Francisco’s HIV-positive community. All HIV-positive San Francisco residents are eligible for our services, which are completely free of cost. We strive to provide culturally appropriate services to our clients, and our team includes attorneys and advocates fluent in Spanish and Mandarin.

Types of Services

Consultation

Advocates provide brief consultation and advice to eligible individuals and service providers on healthcare access issues. Common issues include problems with the following programs:

  • Medi-Cal
  • Medicare
  • Covered CA
  • Private insurance/COBRA
  • AIDS Drug Assistance Program (ADAP)
  • Office of AIDS Health Insurance Premium Payment Program (OA-HIPP)

Intake Services

Advocacy and legal representation is available for eligible individuals facing more complicated health access issues that cannot be addressed through brief consultation.

Outreach and Community Education

EAHP provides healthcare access-related outreach and trainings to community service providers. Training topics include Medi-Cal, Covered CA, Affordable Care Act, and ADAP/OA-HIPP.

For consultations and questions, please call: (415) 777-0333.

This website has been prepared for general information purposes only, and it is not intended to be legal advice.
The information contained in this website cannot replace the advice of competent and licensed legal counsel.

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