Michigan HIV/AIDS Drug Assistance Program (MIDAP) Qualifications
What Is Covered?
MIDAP currently covers HIV-specific and related medicines, as well as vaccines. The MIDAP-eligible drug list and the MIDAP Pharmacy Network List (pharmacies that can fill your prescriptions) can be found at ScriptGuideRX.com/midap.
To be eligible for MIDAP:
- Applicant must provide documentation of HIV disease.
- Applicant must provide proof of residency in the state of Michigan.
- In some cases, applicant must have applied for public assistance (Medicaid and/or Adult Benefits Waiver program) with the Department of Human Services (DHS) within the past 90 days and have a pending, denial, or spend-down status.
- Applicant's gross income cannot exceed 450 percent of the Federal Poverty Level (FPL) and will be evaluated based on FPL guidelines in effect when MIDAP receives your completed application.
How Do I Obtain Services?
Case management and client advocacy agencies, or the MIDAP staff, can assist applicants in completing the MIDAP application. Completed applications will be reviewed and accepted or denied. If approved by the MIDAP, the client will receive a prescription card with a personal identification number.
Forms and Instructions
Please Note: The following forms and documents are available as Adobe Acrobat PDF files. You will need a Adobe Acrobat or Adobe Acrobat Reader to use them. Adobe Acrobat is a free program available through Adobe. Download it now.
- New Application (for clients applying to MIDAP for the first time)
- Six Month Verification (for clients currently on MIDAP who are verifying coverage)
- Annual Recertification Application (for clients currently on MIDAP who are recertifying on an annual basis)
- Frequently Asked Questions About MIDAP
- Michigan Department of Human Services assistance website
- Includes information booklet, application for assistance, and filing form in English (DHS-1171), Spanish (DHS-1171-SP) and Arabic (DHS-1171-AR)
- Affordable Care Act website
HIV Care Section
Division of Chronic Disease and Injury Control
Michigan Department of Community Health
109 Michigan Ave., 9th Floor
Lansing, MI 48913
Phone: 888-826-6565 (toll-free)
Fax (Prescription Copay/Coinsurance): 517-373-1495
Fax (Premium Assistance): 517-335-7723