Almost nobody in the U.S. has to pay full price for HIV medication. Work the doors in order. Get insured if you can, then enroll in your state's ADAP — the Ryan White drug program built for people with low income and limited or no coverage, which can even pay premiums and cost-sharing[1]. Then use the manufacturer's free-drug or co-pay program[2]. In Florida, start today: call 844-381-2327.
Which door first?
Money questions are exhausting on top of everything else. You are not alone. Start with these three doors, in this order, and stop when something covers you — most people end up with a combination rather than one program.
- Insurance first. A Marketplace plan or Medicaid. Being insured does not lock you out of HIV assistance — ADAP is designed to fill in around coverage, and it can pay health insurance premiums and cost-sharing for eligible clients[1].
- ADAP. Your state's AIDS Drug Assistance Program, funded through Ryan White Part B, provides FDA-approved HIV medications to people with low income and limited or no insurance, and every ADAP must cover at least one drug from each class of antiretroviral[1].
- The manufacturer. If you are uninsured, the maker of your medication very likely gives it to you free through a patient assistance program (PAP). If you have commercial insurance, the same companies run co-pay programs with annual caps[2].
Then, if you have insurance and the out-of-pocket cost is still impossible: an independent co-pay foundation. As of today the open HIV fund is Good Days, whose HIV/AIDS Treatment & Prevention fund is listed as open — Good Days notes that funds open and close as money becomes available, so apply promptly rather than later (877-968-7233)[3].
ADAP: the main safety net, and why state rules matter
ADAP is the workhorse. It sits inside Ryan White Part B, which goes to all 50 states, DC, Puerto Rico, the U.S. Virgin Islands, and six territories. Each state sets its own income limit — HRSA says only that it is “usually set as a percentage of the federal poverty level” — and you must live in the state where you apply[1]. There is no single national number, so never assume you earn too much until your state tells you so.
The reason state rules swing so hard is federal funding that has not moved. Ryan White's total appropriation is $2,571,041,000 in FY 2026 — the same as FY 2023, FY 2024, and FY 2025 — and the ADAP line has been flat at $900,313,000 since FY 2019[4]. Flat dollars against rising drug prices and caseloads is what produces state-level eligibility cuts like Florida's in early 2026 (below)[4].
Free medication and co-pay help from the maker
Two different products, often from the same phone number. PAPs give free medication to people who are uninsured. Co-pay programs reduce out-of-pocket costs for people with commercial insurance and have an annual dollar cap. Neither works with Medicaid or Medicare. The table below reflects the federal HIV.gov assistance table (information current as of January 2026, page updated May 7, 2026)[2].
| Medication | Maker | Free-drug PAP income limit (uninsured) | Co-pay cap (commercially insured) | Phone |
|---|---|---|---|---|
| Biktarvy | Gilead | ≤500% FPL | $7,200/yr | 1-800-226-2056 |
| Genvoya | Gilead | ≤500% FPL | $7,200/yr | 1-800-226-2056 |
| Descovy | Gilead | ≤500% FPL | $7,200/yr (drug only — not visits or labs) | 1-800-226-2056 |
| Truvada | Gilead | ≤500% FPL | $7,200/yr (drug only) | 1-800-226-2056 |
| Odefsey | Gilead | ≤500% FPL | $6,000/yr | 1-800-226-2056 |
| Complera | Gilead | ≤500% FPL | $6,000/yr | 1-800-226-2056 |
| Sunlenca (lenacapavir, treatment) | Gilead | ≤500% FPL | $9,600/yr | 1-800-226-2056 |
| Dovato | ViiV | ≤500% FPL | $6,250/yr | 1-844-588-3288 |
| Juluca | ViiV | ≤500% FPL | $6,250/yr | 1-844-588-3288 |
| Triumeq | ViiV | ≤500% FPL | $7,500/yr | 1-844-588-3288 |
| Cabenuva | ViiV | ≤500% FPL | $13,000/yr medical + pharmacy cost sharing; up to $100 per treatment toward administration | 1-844-588-3288 |
| Delstrigo | Merck | ≤400% FPL | $6,800/yr | 800-727-5400 |
| Isentress | Merck | ≤400% FPL | $6,800/yr | 800-727-5400 |
| Symtuza | Johnson & Johnson | ≤300% FPL | $12,500/yr | PAP 833-742-0791 / co-pay 866-836-0114 |
| Prezcobix | Johnson & Johnson | ≤300% FPL | $7,500/yr | PAP 833-742-0791 / co-pay 866-836-0114 |
| Aptivus | Boehringer Ingelheim | ≤250% FPL | none | 800-556-8317 |
Three newer medications are not in the federal table yet, so call rather than guess at a number. Yeztugo (lenacapavir for PrEP) has a Gilead patient assistance program and a co-pay program confirmed on Gilead's own site, but no published income limit or cap — 1-800-226-2056, Mon–Fri 9 a.m.–8 p.m. ET[5]. Apretude (injectable PrEP) has no published PAP income limit, but ViiVConnect's published co-pay program limit is $7,850 per year[6]. Idvynso (doravirine/islatravir) is in Merck's patient assistance program with household income limits of $79,800 for one person, $108,200 for a couple, and $165,000 for a family of four; the Merck Access Program line is 877-709-4455[7].
One application, several manufacturers: HarborPath
If you are uninsured and do not want to fill out five separate applications, HarborPath is one application that feeds multiple manufacturer PAPs. It takes under 15 minutes, you usually hear back in about 24 hours, medication ships in under 48 hours to your home or your clinic, and enrollment lasts up to six months and is renewable. You do not have to apply to other programs first. Office line 980-859-3483[8].
Keep the maker's number handy anyway, because coverage changes matter mid-enrollment: PAP enrollment periods are time-limited with eligibility rechecks, and someone who becomes eligible for Medicaid or ADAP is generally moved to that program instead, since it is the appropriate payer[2].
Co-pay foundations — what is actually open right now
These foundations only help people who have insurance. Two things you should know before you spend an afternoon on applications:
- Good Days — open. Its HIV/AIDS Treatment & Prevention fund is listed as open on the disease-fund index; the award cap is not published on the fund page. Call 877-968-7233[3].
- Patient Advocate Foundation Co-Pay Relief — closed. Its HIV, AIDS and Prevention Health Equity Fund is closed to new and renewal applications for lack of funding, though existing awards are still being honored. Its award level when open was $5,000 a year[9]. Do not build a plan around it today.
- HealthWell Foundation — Medicare only. HealthWell's HIV-related fund covers HIV and AIDS wasting syndrome and anorexia due to HIV or AIDS and requires Medicare; applications are taken by phone only at (800) 675-8416, with average use around $5,300 per 12-month grant. If you have commercial insurance, this fund is not your answer[10].
If none of these land, go back to door two. A Ryan White or 340B-enrolled clinic can often dispense your medication at little or no cost, and your case manager can work the ADAP paperwork with you instead of leaving you to do it alone[1].
Florida: ADAP was cut, then restored — here is exactly where it stands
Florida had a hard year, and the honest version helps you more than a hopeful one. The Department of Health announced cuts in January 2026; in March 2026 ADAP eligibility dropped from 400% to 130% of the federal poverty level and Biktarvy came off the formulary. More than 12,000 Floridians lost coverage[11].
HB 697 was the bridge, not the fix. Signed in March 2026 after passing 38–0 in the Senate and 108–0 in the House, it appropriated $30,901,933 in nonrecurring funds, defined ADAP “low income” as at or below 400% FPL through June 30, 2026, required the formulary to include everything on the March 1, 2026 list, and required direct DOH dispensing plus monthly accounting reports[11]. The permanent restoration came in the FY 2026-27 budget signed June 29, 2026, effective July 1, 2026: eligibility back at 400% FPL, medications restored, and $75 million in additional state funding[11].
Florida DOH now lists eligibility at 0–400% FPL, with Biktarvy and Descovy back on the ADAP formulary as of July 1, 2026 for both direct-dispense clients and CVS Caremark retail clients[12]. Two caveats survived: direct-dispense enrollment is capped at 21,000 people, and insurance premium assistance was not restored — DOH states it is “no longer being provided at this time,” with an independent state review due January 2027[11][12]. If you were relying on premium assistance, or you are worried about the cap, call a Ryan White Part A or B case manager now rather than waiting for a letter.
Florida numbers: HIV/AIDS Hotline 1-800-352-2437 (Spanish 1-800-545-7432; Haitian Creole 1-800-243-7101; TDD/TTY 1-888-503-7118) and the ADAP Help Desk at 844-381-2327 for your eligibility status[12].
Related questions
I have no insurance at all. Can I still get HIV medication?
Yes. Manufacturer patient assistance programs exist specifically for people who are uninsured and give brand-name HIV medication at no cost — Gilead at 1-800-226-2056, ViiV at 1-844-588-3288, Merck at 800-727-5400, Johnson & Johnson at 833-742-0791. HarborPath is a single application that feeds several of those programs, ships in under 48 hours, and does not require you to apply anywhere else first. Your state ADAP is the other main door, and a Ryan White clinic can enroll you in both.
Does having insurance disqualify me from help?
No, and it usually helps. ADAP is built to fill in around coverage and can pay health insurance premiums and cost-sharing for eligible clients, and manufacturers run co-pay programs with annual caps for people with commercial insurance — for example $7,200 a year for Biktarvy and $6,250 for Dovato. The programs that will not work with public coverage are the manufacturer co-pay cards, which exclude Medicaid and Medicare.
Which independent co-pay foundation should I apply to for HIV?
Good Days is the one currently listed as open for HIV/AIDS treatment and prevention — call 877-968-7233, and apply promptly, because these funds open and close as money becomes available. The Patient Advocate Foundation's HIV fund is closed to new and renewal applications for lack of funding. HealthWell's HIV-related fund requires Medicare, covers wasting syndrome and anorexia due to HIV, and takes applications only by phone at (800) 675-8416.
What is Florida ADAP's income limit in 2026?
At or below 400% of the federal poverty level. Florida cut it to 130% FPL in March 2026, HB 697 bridged it back to 400% FPL through June 30, 2026, and the FY 2026-27 state budget signed June 29, 2026 made 400% FPL permanent effective July 1, 2026 with $75 million in additional funding. Two limits remain: direct-dispense enrollment is capped at 21,000 people, and premium assistance is not currently offered. Call 844-381-2327 to check your status.
Related from RiseUpToHIV
References & Sources
- HRSA Ryan White — Part B: AIDS Drug Assistance Program (ADAP). What ADAP covers, the minimum formulary requirement, premium and cost-sharing assistance, state-set income limits, and the residency rule. ↩ ↩ ↩ ↩ ↩
- HIV.gov — Patient Assistance Programs and Co-payment Assistance Programs. Federal drug-by-drug table of PAP income limits, co-pay program annual caps, and manufacturer phone numbers; information current as of January 2026, page updated May 7, 2026. ↩ ↩ ↩ ↩
- Good Days — HIV, AIDS Treatment & Prevention fund. The open HIV co-pay fund and its 877-968-7233 line; Good Days notes funds open and close as funding becomes available. ↩ ↩
- HRSA Ryan White — Program Funding (FY 2015–FY 2026 appropriations). FY 2026 total of $2,571,041,000, unchanged since FY 2023, and the ADAP line flat at $900,313,000 since FY 2019. ↩ ↩
- Gilead — Yeztugo cost and coverage. Confirms a Gilead patient assistance program and co-pay program for Yeztugo, with no published income limit or annual cap, and the 1-800-226-2056 line (Mon–Fri 9 a.m.–8 p.m. ET). ↩
- ViiVConnect — Co-Pay Program eligibility requirements and restrictions (PDF). Published $7,850 annual co-pay program limit for Apretude. ↩
- Merck Helps — Idvynso patient assistance. Household income limits of $79,800 (individual), $108,200 (couple), and $165,000 (family of four), and the Merck Access Program line 877-709-4455. ↩
- HarborPath — Patient application. One application into multiple manufacturer PAPs: under 15 minutes, ~24-hour response, shipping in under 48 hours, six-month renewable enrollment, no requirement to apply elsewhere first; 980-859-3483. ↩
- Patient Advocate Foundation Co-Pay Relief — HIV, AIDS and Prevention Health Equity Fund. Fund closed to new and renewal applications for lack of funding; existing awards honored; $5,000 annual award level when open. ↩
- HealthWell Foundation — HIV and AIDS Wasting Syndrome and Anorexia due to HIV or AIDS, Medicare Access fund. Medicare required, phone-only applications at (800) 675-8416, average use around $5,300 per 12-month grant. ↩
- AIDS Healthcare Foundation — Florida budget becomes law, securing reversal of HIV drug cuts (June 2026). Timeline of the January–March 2026 cuts and the 12,000+ people affected; HB 697's $30,901,933 bridge; the FY 2026-27 budget signed June 29, 2026 with $75 million effective July 1, 2026; the surviving 21,000-person direct-dispense cap and unrestored premium assistance. ↩ ↩ ↩ ↩
- Florida Department of Health — AIDS Drug Assistance Program (ADAP). Current 0–400% FPL eligibility, Biktarvy and Descovy returning to the formulary July 1, 2026, the statement that premium assistance is no longer being provided at this time, and the ADAP Help Desk and hotline numbers. ↩ ↩ ↩
Community publications like POZ, Positively Aware, and TheBody inform framing and lived-experience context on RiseUpToHIV. Every clinical, epidemiological, or public-health claim above is anchored to a primary source.