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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 98TEXAS HIV MEDICATION PROGRAM
SUBCHAPTER CTEXAS HIV MEDICATION PROGRAM
DIVISION 1GENERAL PROVISIONS
RULE §98.104Specific Program Eligibility Criteria

(a) AIDS Drug Assistance Program (ADAP). In addition to §98.103 of this title (relating to THMP Eligibility Criteria), an individual must attest that the individual is not enrolled in any state, federal, or private health insurance policies or benefits programs that cover the individual's currently prescribed medications that are on the THMP formulary.

(b) SPAP. In addition to §98.103 of this title, an individual must be enrolled in a Medicare prescription drug plan that covers the individual's current medications that are on the formulary and apply for low-income subsidy (LIS) assistance. Those approved with full-LIS are disenrolled from the SPAP program, while those with partial-LIS and who are denied LIS remain eligible for participation in SPAP. (Information on Medicare eligibility, Medicare prescription drug plans and LIS assistance can be found at http://www.medicare.gov.)

(c) TIAP. In addition to §98.103 of this title, an individual must be enrolled in an eligible health insurance policy that covers the individual's current medications on the formulary, as updated. An applicant may be screened for TIAP during open enrollment or when the applicant has experienced a qualifying event.


Source Note: The provisions of this §98.104 adopted to be effective November 17, 2022, 47 TexReg 7557

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