New York State offers vital Uninsured Care Programs designed to provide free healthcare services to residents who lack health insurance or are underinsured. These programs ensure access to essential medical care, including medications, primary care, home care, insurance premium assistance, and preventive measures like Pre-Exposure Prophylaxis (PrEP) for HIV prevention. Committed to supporting both individuals and healthcare providers, the Uninsured Care Programs navigate the complexities of healthcare payment options for those living with or at risk of HIV/AIDS.
Updated Hours of Operation (Effective March 18, 2024):
The Uninsured Care Programs operate from Monday to Friday, 9:00 AM to 5:00 PM.
Contact Information:
- In State (Toll-Free): 1-800-542-2437 or 1-844-682-4058
- Out of State: (518) 459-1641
Please note the office will be closed on the following holidays in 2025: Monday, February 17, Monday, May 26, Thursday, June 19, Friday, July 4, Monday, September 1, Monday, October 13, Thursday, November 11, Thursday, November 27, and Thursday, December 25. Plan accordingly when seeking assistance during these times.
Streamlined Access Through the Uninsured Care Programs Portal
To enhance accessibility and security, the Uninsured Care Programs feature an online portal. This digital platform simplifies the submission process for program applications and recertification documents.
Alt text: A person uses a laptop to navigate the online portal for New York State Uninsured Care Programs, highlighting digital access to healthcare applications.
For New Applicants: The portal enables first-time applicants to securely complete and submit their applications alongside necessary supporting documents. This includes medical forms, proof of income and New York State residency, and any other required verification.
For Existing Participants: Current program participants can efficiently submit their recertification documents through the portal, ensuring continued access to vital healthcare services.
This online system is also available in Spanish, catering to a broader range of applicants and participants.
Comprehensive Drug Formulary and Service Coverage
The Uninsured Care Programs offer a robust formulary of medications and a wide array of covered services to address various healthcare needs.
Cabenuva Coverage Instructions for ADAP
For providers enrolled in the AIDS Drug Assistance Program (ADAP) or ADAP Plus Program, the Uninsured Care Programs facilitate the use of their Cabenuva inventory. It is important to note that medications acquired under the Public Health Service (PHS) Section 340B cannot be used for New York State ADAP participants.
To ensure seamless access to Cabenuva, prescribing practitioners should contact an enrolled pharmacy to arrange direct shipment to their office. The pharmacy will then handle billing the ADAP participant’s insurance and/or ADAP. Participants will incur no out-of-pocket expenses for Cabenuva when obtained through an enrolled pharmacy. For claim submissions related to a participant’s medical benefit for Cabenuva, please contact the program helpline at 1-800-732-9503, extension 2, to speak with a supervisor for guidance.
ADAP Coverage for Office Visits and Administration Fees
To eliminate out-of-pocket costs for office visits and administration fees for active ADAP Plus participants, healthcare providers must be part of the ADAP Plus network. Enrolled providers can directly bill ADAP Plus for these services. Participants who seek care from providers outside the ADAP Plus network may be responsible for both the office visit fee and the drug administration costs.
For any inquiries regarding ADAP and ADAP Plus coverage details, please reach out to the dedicated helpline at 1-800-542-2437 or 1-844-682-4058.
Alt text: A healthcare professional explains the benefits of uninsured care programs to a patient in a consultation room, emphasizing personalized healthcare guidance.
Uninsured Care Programs: A Summary of Eligibility and Support
If you are a New York State resident without health insurance, or if you possess health insurance but struggle with out-of-pocket expenses such as copays and deductibles, the Uninsured Care Programs may offer crucial assistance. Eligibility extends to households with incomes below 500% of the Federal Poverty Level (FPL).
Whether you choose to apply independently or seek assistance from your healthcare provider, the application process requires documentation of income, proof of New York State residency, and copies of any existing health insurance cards. Click here for examples of acceptable documentation for residency and income verification. Complete applications are typically processed swiftly, often within 1-3 business days, and in many cases, on the same day.
For clarification on documentation requirements or any questions about the enrollment process, please contact the Uninsured Care Programs toll-free at 1-800-542-2437 or 1-844-682-4058.
Key Programs Under the Uninsured Care Umbrella
The Uninsured Care Programs encompass several specialized programs tailored to specific needs:
AIDS Drug Assistance Program (ADAP)
ADAP plays a critical role in providing free medications for the treatment of HIV/AIDS and related opportunistic infections. By ensuring access to these essential drugs, ADAP significantly improves the health and longevity of individuals living with HIV/AIDS, effectively managing symptoms and enhancing quality of life.
ADAP Plus (Primary Care)
ADAP Plus focuses on delivering free primary care services through a network of selected clinics, hospital outpatient departments, physician offices, and lab vendors. Services include comprehensive ambulatory care, early intervention strategies, and continuous treatment management, ensuring holistic healthcare access.
HIV Home Care Program
For chronically ill and medically dependent individuals, the HIV Home Care Program offers coverage for necessary home care services as prescribed by a physician. This includes skilled nursing care, home health aide services, intravenous therapy, medications and supplies, and durable medical equipment, all delivered through enrolled home care agencies.
Alt text: A home healthcare nurse provides attentive care to a patient at home, representing the personalized services offered by the HIV Home Care Program.
ADAP Plus Insurance Continuation Program (APIC)
APIC provides financial support by covering commercial health insurance premiums for ADAP-eligible clients. The program prioritizes cost-effective, comprehensive health insurance policies that offer full prescription and primary care coverage without restrictive annual coverage limits.
Pre-Exposure Prophylaxis Assistance Program (PrEP-AP)
PrEP-AP supports eligible providers in delivering a range of services to eligible individuals, including HIV testing, STI/STD testing, and supportive primary care services, all aligned with established PrEP clinical guidelines. This program is crucial in preventing new HIV infections within New York State.
Access Application Forms and Additional Resources
For easy access, application forms are available in both English and Spanish:
- [Uninsured Care Programs Application (English)]()
- [Solicitud para el Programa Uninsured Care (Español)]()
Additional resources and provider information are also readily accessible:
- [Other Resources]()
- [Uninsured Care Programs Provider Assurances & Agreements with Enrollment Form]()
- [Uninsured Care Programs Provider/Service Manuals]()
For alternate format requests or further inquiries, please contact [email protected].
Mailing Address:
[Address information would be here if provided in the original text – Please insert if available]
By leveraging these Uninsured Care Programs, New York State is dedicated to ensuring that all residents, regardless of their insurance status, have access to the healthcare services they need to live healthy lives.
