HIV Medications and Pre-Exposure Prophylaxis (PrEP)

Please pay close attention to the following as there are CRITICAL differences in how HIV/AIDS and Pre-Exposure Prophylaxis (PrEP) medications are adjudicated in the District of Columbia.

Healthy Families members may fill HIV and AIDS medications at any in-network retail pharmacy.

For members in Alliance, medications for the treatment of HIV and AIDS are supplied through the AIDS Drug Assistance Program (ADAP). All members must apply to the ADAP program and renew every 6 months. Prescriptions for HIV and AIDS medications must be filled at ADAP-participating pharmacies.

Prescriptions for PreP (HIV pre-exposure prophylaxis) may be filled at any in-network pharmacy for members of Healthy Families and Alliance.  PLEASE note ON THE PRESCRIPTION that the intended use of the medication is for PrEP as this will assist the pharmacy in processing the prescription expeditiously.  For example, include the phrase, “for PrEP” anywhere on the prescription.

 

DC HEALTHY FAMILIES MEMBERS

DC HEALTHCARE ALLIANCE MEMBERS

Member has HIV/AIDS

Any in-network pharmacy

ADAP Pharmacy

Member desires PrEP

Any in-network pharmacy

Any in-network pharmacy

For information on the preferred (formulary) HIV medications for Alliance members, please click the  LINKS below.  This document lists the drugs that are available through the District of Columbia AIDS Drug Assistance Program.

MEDICATIONS SUPPLIED THROUGH ADAP PHARMACIES
https://dchealth.dc.gov/sites/default/files/dc/sites/doh/service_content/attachments/ADAP%20Formulary%20July%202020.pdf

LIST OF ADAP-PARTICIPATING PHARMACIES
https://dchealth.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/HIV%20AIDS%20Pharmacy%20Provider%20Network%20%20%28%20Feb%202020%29.pdf

Information current as of: 10/20/20