Section R9-6-403. Eligibility Requirements

An individual is eligible to enroll in ADAP if the individual:

1.        Has a diagnosis of HIV infection from a physician, regis- tered nurse practitioner, or physician assistant;

2.        Is a resident of Arizona, as established by documentation that complies with R9-6-404(A)(9);

3.        Has an annual family income that is less than or equal to 300% of the poverty level;

4.        Satisfies one of the following:

a.        Has no health insurance coverage;

b.        Has health insurance coverage that:

i.         Does not cover drugs, or

ii.        Does not include on its formulary at least one of the drugs prescribed for the individual that is on the ADAP formulary;

c.        Is an American Indian or Alaska Native who:

i.         Is eligible for, but chooses not to use, the Indian Health Service to receive drugs; and

ii.        Either has no other health insurance coverage or has health insurance coverage that:

(1)     Does not cover drugs, or

(2)     Does not include on its formulary at least one of the drugs prescribed for the individual that is on the ADAP formulary; or

d.        Is a veteran who:

i.         Is eligible for, but chooses not to use, Veterans Health Administration benefits to receive drugs; and

ii.        Either has no other health insurance coverage or has health insurance coverage that:

(1)     Does not cover drugs, or

(2)     Does not include on its formulary at least one of the drugs prescribed for the individual that is on the ADAP formulary;

5.        Is ineligible for enrollment in AHCCCS, as established by documentation issued by AHCCCS; and

6.        If eligible for Medicare:

a.        Is ineligible for a full low-income subsidy, as estab- lished by documentation issued by the Social Secu- rity Administration; and

b.        Has enrolled in a Medicare drug plan.

Historical Note

Adopted as an emergency effective January 12, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-1). Emergency expired. Readopted without change as an emergency effective May 9, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-2).

Amended and readopted as an emergency effective August 8, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-3). Emergency expired.

Readopted without change as an emergency effective November 16, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired.

Amended subsection (B) and adopted as a permanent rule effective May 22, 1989 (Supp. 89-2). Amended as an emergency effective August 8, 1990, pursuant to A.R.S. §

41-1026, valid for only 90 days (Supp. 90-3). Emergency expired. Emergency amendments re-adopted without change effective November 19, 1990, pursuant to A.R.S.

§ 41-1026, valid for only 90 days (Supp. 90-4). Emer- gency expired. Emergency amendments re-adopted with- out change effective February 28, 1991, pursuant to

A.R.S. § 41-1026, valid for only 90 days (Supp. 91-1). Emergency expired. Renumbered from R9-6-803 and amended effective October 19, 1993 (Supp. 93-4). For- mer Section R9-6-403 renumbered to R9-6-404; new

Section R9-6-403 renumbered from R9-6-402 and amended by final rulemaking at 8 A.A.R. 1953, effective April 3, 2002 (Supp. 02-2). Amended by final rulemaking

at 13 A.A.R. 3329, effective November 10, 2007

(Supp. 07-3).