AIDS Drug Distribution Program (ADDP)
New Jersey Health Insurance Continuation Program (HICP)
The ADDP provides financial assistance to New Jersey AIDS patients who are unable to afford their AIDS medication.
The HICP allows AIDS patients to keep their health insurance when they can no
longer work or when they can only work part time. If you qualify, HICP will pay
the monthly payments (premiums) for your health insurance, including family
insurance that covers your spouse and/or children.
Application Process:
** Applications are available for download at the bottom of this page. **
Complete application and mail to:
The HICP allows AIDS patients to keep their health insurance when they can no
longer work or when they can only work part time. If you qualify, HICP will pay
the monthly payments (premiums) for your health insurance, including family
insurance that covers your spouse and/or children.
Application Process:
** Applications are available for download at the bottom of this page. **
Complete application and mail to:
For ADDP:
ADDP P.O Box 722 Trenton, NJ 08625 or fax applications to: 609-588-7037 |
For HICP:
NEW JERSEY DEPARTMENT OF HEALTH HEALTH INSURANCE CONTINUATION PROGRAM PO BOX 363 TRENTON, NJ 08625-0363 or fax applications to: 609-984-6495 |
Eligibility Requirements:
Applicants:
1.) Must be a New Jersey resident at least 30 days prior to submitting an application.
2.) Annual Income must not exceed 500% of the federal poverty line. (Income table below.)
3.) Applicants must provide a completed authorization form from a Physician certifying the need for medical assistance.
4.) A completed consent form must be submited with each application.
5.) FOR ADDP ONLY: Applicants with private health insurance must demonstrate that they have already exhausted all available benefits under their insurance plan.
6.) FOR HICP ONLY: Applicants must be previously enrolled in a health insurance program.
7.) Providing your Social Security Number is mandatory for the processing of your application.
Applicants:
1.) Must be a New Jersey resident at least 30 days prior to submitting an application.
2.) Annual Income must not exceed 500% of the federal poverty line. (Income table below.)
3.) Applicants must provide a completed authorization form from a Physician certifying the need for medical assistance.
4.) A completed consent form must be submited with each application.
5.) FOR ADDP ONLY: Applicants with private health insurance must demonstrate that they have already exhausted all available benefits under their insurance plan.
6.) FOR HICP ONLY: Applicants must be previously enrolled in a health insurance program.
7.) Providing your Social Security Number is mandatory for the processing of your application.
Income Requirements:
ADDP Income Requirement (Updated Jan 24, 2013)
HICP Income Requirement (Updated Jan 24, 2013)
Applications for the ADDP and HICP Programs
ADDP Application | |
File Size: | 52 kb |
File Type: |
HICP Application | |
File Size: | 30 kb |
File Type: |
Physician Certification | |
File Size: | 12 kb |
File Type: |
addpappeng3.pdf | |
File Size: | 11 kb |
File Type: |
For more information please see:
http://www.state.nj.us/health/aids/freemeds.shtml (For ADDP)
http://www.state.nj.us/health/aids/keepins.shtml (For HICP)
http://www.state.nj.us/health/aids/freemeds.shtml (For ADDP)
http://www.state.nj.us/health/aids/keepins.shtml (For HICP)
Youth Empowerment Services | 270 George St., New Brunswick, NJ 08901 | Phone: 732-YES-YESS | www.youthempowermentservices.us