The Ohio Department of Health (ODH) administers the Ohio HIV Drug Assistance Program (OHDAP) and the Health Insurance Premium Payment (HIPP) Program.

Ohio HIV Drug Assistance Program (OHDAP)

The OHDAP formulary provides medications to treat HIV and HIV-related conditions. The program is one of last resort, meaning the program can help cover some of the costs associated with living with HIV not otherwise covered by insurance or other community resources. For eligible participants, medications included in the OHDAP formulary are provided free of charge. The medications are available through a mail-order pharmacy or from an OHDAP contracted retail location. An applicant must be a resident of Ohio, be HIV positive, meet financial eligibility guidelines, and re-enroll every six months. 

Eligibility and Enrollment

To be eligible for OHDAP, the individual must:

• Submit a complete Ryan White Part B Program application, demonstrate a willingness to sign all forms, and provide necessary documentation.
• Be a resident of Ohio.
• Have a gross monthly income that meets OHDAP financial eligibility guidelines. (This income amount is adjusted for family size.) This form should become available in April of each year. Applicants with an income at or below the federal poverty level are required to have an ODH-approved Ryan White Part B medical case manager who can assist with accessing all eligible services.
• Provide proof of monthly income (for the applicant, as well as the applicant's legal spouse and/or dependents). This includes four consecutive weeks of current pay stubs (within 90 days of application submission date), current Social Security Income award letters, copies of unemployment compensation stubs, etc.
• Provide a copy of an IRS Income Tax Transcript for the most recent tax year, if self-employed. The form to obtain the transcript is Form 4506T and is available at the IRS Web site. Step-by-step instructions are also available by following the IRS transcript request instructions.
• Provide documentation of HIV positive status (e.g., lab results, documentation by a medical provider, etc.), if a first-time applicant.

Any participant found to be submitting fraudulent information may be expelled from this and other Ryan White Part B and OHDAP programs.

The OHDAP formulary is an open formulary with some specific and class exclusions. This means that the exclusions list shows which medications are not covered by OHDAP. A list of excluded medications is available to all program participants and interested parties. OHDAP allows for two refills for each prescription submitted to the pharmacy. No co-payment is required. The participant's prescriber must call in a new prescription every three months. When it is time for a refill, the program’s contracted pharmacy will call the participant to see if there are any changes regarding the participant's account. A 30-day supply of approved medications will be provided by mail or from an OHDAP contracted retail location each month a participant is enrolled in the program. When a participant's OHDAP enrollment ends, medications will no longer be covered, even if there are refills left.

Health Insurance Premium Payment (HIPP) Program

ODH administers the HIPP Program for people living with HIV. The HIPP Program provides premium assistance for an OHDAP participant's portion of their insurance premiums, if eligible. The program is one of last resort, meaning the program can help cover some of the costs associated with living with HIV not otherwise covered by insurance or other community resources.

Eligibility and Enrollment

To be eligible for the HIPP program, the individual must:

• Submit a complete Ryan White Part B Program application, demonstrate a willingness to sign all forms, and provide necessary documentation.
• Be a resident of Ohio.
• Have a gross monthly income of less than, or equal to, 500 percent of the federal poverty level. (This income amount is adjusted for family size.)
• Provide proof of monthly income (for the applicant, as well as the applicant's legal spouse and/or dependents). This includes four consecutive weeks of current pay stubs (within 90 days of application submission date), current Social Security Income award letters, copies of unemployment compensation stubs, etc.
• Provide a copy of an IRS Income Tax Transcript for the most recent tax year, if self-employed. The form to obtain the transcript is Form 4506T and is available at the IRS Web site. Step-by-step instructions are also available by following the IRS transcript request instructions.
• Provide documentation of HIV positive status (e.g., lab results, documentation by a medical provider, etc.), if a first-time applicant.
• Have current primary health insurance coverage or be eligible for continued coverage (COBRA); the policy must include prescription drug coverage.

The covered individual is responsible for notifying ODH of any changes in income status, mailing address, insurance coverage, insurance premium rate, and other information, as necessary, to maintain program eligibility. Failure to notify ODH may affect enrollment and/or result in an interruption of services.

Any participant found to be knowingly submitting fraudulent information may be expelled from this and other Ryan White Part B and OHDAP programs for a period of up to 12 months.

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