Equal Access To Healthcare Program

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

This year’s report showcases program outcomes and successes, and also provides practical advice to consumers and service providers on how to navigate complex healthcare systems. One of the major features in this year’s report is a map of all the ADAP enrollment sites in San Francisco including contact information for each site. The report also includes a list of helpful phone numbers and a section on the recent changes to the AIDS Drugs Assistance Program and the Office of AIDS Health Insurance Premium Payment Program.

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

Effective July 1, 2016, major changes will take effect to ADAP, OA-HIPP, and the Medicare Part D Premium Payment Program. Here are the most important changes you need to know:

  • Ramsell will no longer administer ADAP. Ramsell will be replaced by Magellan Rx to administer pharmacy benefits.
  • Ramsell prescription benefit cards will deactivate on July 1, 2016. New Magellan Rx prescription benefit cards will be issued in June 2016.
  • ADAP client ID numbers will remain the same. Clients should be able to access medication without a Magellan Rx prescription benefit card if they use a pharmacy in the Magellan Rx network.
  • Magellan Rx’s network includes over 6,000 pharmacies and most clients will not need to change pharmacies.
  • OA-HIPP will start paying out-of-pocket medical costs (deductibles, co-pays, coinsurance) up to the insurance plans’ annual maximum.
  • Pool Administrators Inc. (PAI) will administer OA-HIPP and the Part D Premium Payment program.
  • Enrollment in all programs will be done through a central web-based portal administered by AJ Boggs.

Tips for Resolving Pharmacy Issues

  1. Contact your ADAP Enrollment Worker to support problem resolution.
  2. Ask the pharmacist to call Magellan Rx Client Services regarding pharmacy network or benefits questions at 1-800-424-5906.
  3. Call CA Office of AIDS with any questions at 1-844-421-7050.
  4. Starting July 1, 2016, call AJ Boggs to resolve enrollment and eligibility issues at 1-844-550-3944.

Important Phone Numbers

  • Magellan Rx Client Services: 1-800-424-5906
  • CA Office of AIDS: 1-844-421-7050
  • AJ Boggs: 1-844-550-3944 (starting July 1, 2016)

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 $58,850/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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