ADAP in Hawaii — AIDS Drug Assistance Program eligibility and enrollment

Hawaii Drug Reimbursement Program (HDRP, Hawaii's ADAP) serves 420 people, with an income eligibility cap at 400% of the federal poverty line. In Hawaii that means your gross annual income can be up to $61,004 for a household of one (at 2025 HHS poverty guidelines) and you still qualify. ADAP is the 'payer of last resort' for HIV medications: it covers people with no insurance, fills the gap for people on Medicare Part D, and pays co-pays for people on commercial insurance.

What ADAP covers: all FDA-approved antiretroviral medications on the state formulary (every ADAP covers the WHO-recommended first-line regimens), plus many opportunistic-infection prophylaxis drugs, lab work in states where the ADAP pays for labs directly, and in some states hepatitis B and C treatment. Hawaii Drug Reimbursement Program (HDRP, Hawaii's ADAP)'s formulary is published on the state health department website and is updated at least annually.

How to enroll: a case manager at a Ryan White Part B or Part C clinic completes the application with you. You'll need proof of HIV diagnosis (a lab report or physician letter), proof of Hawaii residency, proof of income (pay stubs, tax return, benefit letter), and documentation of insurance status. Decisions typically return within two weeks; medications are dispensed through participating pharmacies at no cost once you're enrolled. Recertification is annual.

The state HIV info line is 1-808-733-9010; the case-management team can match you to the nearest Ryan White clinic for same-week intake. Long-time Black residents name Hawaii Health and Harm Reduction Center and Queen's Medical Center Infectious Disease Clinic as the local institutions that show up consistently — both are listed below.

Hawaii Health and Harm Reduction Center. Hawaii Health and Harm Reduction Center in Honolulu (formerly Life Foundation) is the state's largest HIV service organization, operating Ryan White Part B case management, rapid testing at its Keeaumoku Street clinic, and the Kua'ana Project for Native Hawaiian and Pacific Islander people living with HIV.

Queen's Medical Center Infectious Disease Clinic. The Queen's Medical Center ID Clinic in Honolulu is the Ryan White Part C grantee for Oahu and the outer islands, with a telehealth program that covers Maui, Kauai, and the Big Island where no other ID specialist accepts HIV patients.