Virginia

This information has not yet been verified for all of the persons listed on the Virginia pages. Please contact us if you have changes or corrections. Thank You.

The state of Virginia maintains an extensive website that provides information on many different health care resources throughout the state. They also provide recently updated manuals and guides that can be dowloaded in PDF form. Their hotline will mail information to you upon request.

• Virginia HIV/STD/Viral Hepatitis Division


• Virginia HIV/STD/Viral Hepatitis Hotline - (800) 533-4148
The Virginia HIV/STD/Viral Hepatitis Hotline provides statewide toll-free lines to answer questions and provide crisis intervention, referrals and written educational materials regarding Sexually Transmitted Diseases (STDs), HIV and AIDS. You can also e-mail the hotline at hiv-stdhotline@vdh.virginia.gov. The Hotline mails out informational pamphlets, brochures and posters to groups, individuals and organizations. There is also The Virginia Transgender Resource and Referral List that includes resources for the transgender community in Virginia.


• Bureau of Insurance Medicare Providers List


• Senior's Manual (Medicaid, Medicare, Food Stamps, etc. Intended for Seniors, but an incredibly comprehensive resource on many topics)

ADAP Eligibility and Enrollment Information

• State ADAP Director
  Faye Bates, RN
  ADAP Coordinator
  Division of Disease Prevention
  Virginia Department of Health
  Phone: (804) 864-8019
  faye.bates@vdh.state.va.us

• Yearly family income cannot be more than 300% of the federal poverty level (FPL); for Northern Virginia the number is slightly higher at 333%.


• You are not required to live in the heath district where they recieve ADAP. HIV+ pregnant women or newborn infants of HIV-infected mothers are eligible for antiretrovirals regardless of the CD4 count or viral load.


• If you have no income, you need to bring either a signed letter of support, or evidence of employment status to the local health department. This documentation does not need to be notarized.


• Clients must have no third party insurance coverage for the prescribed medication(s). All client eligibility for ADAP is determined at local health departments or through Virginia Commonwealth University Health Systems Financial Counseling and Governmental Services. Veterans who meet all ADAP eligibility criteria can access covered medications through ADAP.


• New ADAP clients currently on antiretroviral therapy are not required to meet the CD4 and viral load requirements. A statement documenting current antiretroviral treatment and previous source of funding must be reported to the ADAP coordinator. You will need to provide written prescriptions for all requested medications. Documentation of CD4 and viral load counts are required for some medications.

About Virginia

• State and National Resources : Virginia specific contact information for different programs through which you can access a variety of services. This page also includes national resources, and links to other sources.


• Care Networks and Care Providers : Virginia has Ryan White Care Act Part B (HIV Care Consortia) agencies and organizations that can either provide or refer you to a case manager or a health care provider. The participating agencies are listed, as are some other resources.


• Accessing Treatments and other Resources : Virginia has a list or formulary of drugs and other services they cover through ADAP and other programs.Other potential sources of treatments for people with HIV or Hepatitis are also listed.


• Hepatitis Resources : Virginia has statewide Hepatitis vaccination programs, and covers some treatments for hepatitis B and Hepatitis C through their program.

Virginia Access - ADAP eligibility must be recertified every 12 months. You are required to report changes in income, insurance or Medicaid status when they occur. Failure to report changes in factors impacting eligibility may result in discontinuation of ADAP services. Clients shall be considered ineligible for ADAP after two documented attempts by local health department staff to obtain proof of income, insurance or Medicaid status.

You must be ineligible for Virginia Medicaid . The Medicaid Referral Assessment Form provides a means to screen ADAP clients to determine whether referral to Department of Social Services to submit a Medicaid application is indicated. The local health department will provide you with medications through ADAP until Medicaid is approved.

To remain eligible for ADAP, you must submit proof of Medicaid ineligibility within 90 days of Medicaid application. If you lose Medicaid coverage, medications will again be provided through ADAP.

Sometimes a state has a waiting list people have to stay on until spaces become available. Check to see if there is a waiting list for the program by contacting them directly. According to NASTAD's most recent ADAP Watch Virginia does not have a waiting list. Do not ever drop your private insurance without first seeing if your state will cover part or the whole premium, especially if you have children.

ADAP and Medicare Part D Eligibility

• Medicare eligibility status must be assessed at initial enrollment and annually.
  Federal policy requires that ADAP clients who are eligible for Medicare enroll in the Medicare Part D benefit. However, if a client refuses enrollment after extensive counseling about this benefit and has no other viable option for obtaining medications other than ADAP, please document the reason for not enrolling on the CHS-1 or equivalent eligibility form and allow the client to access medications through ADAP. Please fax the documentation of refusal to the VDH ADAP Coordinator at 804 864-8050.
  Medicare eligible clients with incomes less than 150% of the FPL must apply for the low-income subsidy (LIS) or “extra-help” component of the Part D benefit to assist with the client’s share of out-of-pocket costs. Medications can be accessed through ADAP until LIS eligibility determination is received. The ADAP Medicare Assessment Form is to be utilized to track application outcome.
  Medicare Part D enrolled ADAP clients with incomes above 150% of FPL and those who do not qualify for the LIS will be allowed to continue to receive medications through ADAP. This is to be documented on the Medicare Part D Assessment Form. Clients who qualify for the LIS will need to utilize their Medicare Part D Plan for their medications.
  Medicare eligible clients who qualify for the low income subsidy, with incomes 135% to 150% FPL, and are unable to obtain assistance with Part D cost sharing may request an ADAP eligibility exception through the local health department. The local health department will complete the ADAP Medicare Part D Eligibility Exception Form and submit to the VDH ADAP Coordinator. These requests will be reviewed on a case-by-case basis

  ADAP clients with Medicare coverage who are on a Medicaid “spend down” will be automatically enrolled in a Part D plan as a dual eligible when their “spend down” is met. They will no longer be eligible for ADAP and will need to utilize their Part D plan.