Example

Donald’s Story

Donald is a self-employed musician. He has been making a decent living for the last several years and because he was healthy, fit, and not even 30 years old, he only had a catastrophic health plan he got through HealthCare.gov.

He recently got tested for HIV and found out that he was HIV-positive. After that, he went to a doctor, who told Donald that he’d have to start taking a lot of prescription drugs.

Donald realized that because of his plan's high deductible, he wouldn't be able to afford all of the medications he'd need. And, even if he managed to pay that big deductible, his plan wouldn't pay for all of the medications he needed, because some of them were not on his plan's formulary — so he called up the Arizona AIDS Drug Assistance Program (ADAP) at 1-800-334-1540.

ADAP supplies HIV/AIDS-related prescription drugs to uninsured and underinsured people living with HIV/AIDS. Donald contacted an ADAP case manager, who helped him apply. He qualified for the program because he was HIV-positive, earned less than 300% of the Federal Poverty Guidelines ($3,765 a month), and was underinsured, meaning that his health insurance did not provide adequate coverage for the HIV/AIDS-related drugs Donald needed.