The Ryan White HIV/AIDS Program is the federal safety net built specifically for people living with HIV. It is not insurance and not Medicaid — it is a grant program that funds medical care, medications, and services like case management and transportation[1]. There are only three eligibility factors, and citizenship is not one[2]. Find a provider at findhivcare.hrsa.gov, or in Florida call 1-800-352-2437.
What Ryan White actually is
Ryan White was first enacted in 1990 and is administered by the HIV/AIDS Bureau at HRSA, inside the U.S. Department of Health and Human Services. It is the largest federal program designed specifically for people with HIV and the third largest federal source of HIV care funding, after Medicare and Medicaid[1]. Congress funds it; HRSA administers it; your local clinic, county health department, or state health department is what you actually walk into.
The scale is the reassuring part. More than half of everyone diagnosed with HIV in the U.S. receives Ryan White services each year — HRSA reported more than 576,000 people served in 2023[3]. And the people it serves look like everyone: in 2022, 59% of clients were at or below the federal poverty level and another 28% were between 101% and 250% FPL; 18% were uninsured while 39% had Medicaid, 20% private coverage, and 10% Medicare only; 72% were people of color[1].
Am I eligible? There are exactly three factors
HRSA's Policy Clarification Notice 21-02 (revised March 13, 2025) sets three requirements, and you must meet all three[2]:
| Factor | What it means |
|---|---|
| HIV status | A documented diagnosis of HIV. Some services are available to people without an HIV diagnosis, such as partners and family members, under a separate policy notice. |
| Low income | Your local grantee defines “low income.” It may be measured as a percentage of the federal poverty level using modified adjusted gross income, adjusted gross income, individual gross income, or household gross income. There is no single federal number. |
| Residency | The grantee defines residency within its service area — meaning where you live, not your immigration status. |
You will see “500% FPL for services, 400% FPL for ADAP” repeated all over the internet. Those are typical state practice, not federal rules. HRSA sets no numeric federal income ceiling for Ryan White services, and each state sets its own ADAP limit, usually as a percentage of the poverty level[2][4]. Check your state's number, and do not rule yourself out based on a national figure that does not exist.
What is not required — the four worries we hear most
PCN 21-02 addresses these directly, and it is worth knowing so you can advocate for yourself at the front desk[2].
- Citizenship and immigration status are not eligibility factors. The three factors are HIV status, income, and residency, and residency means living in the service area[2].
- You do not have to appear in person or get documents notarized. HRSA does not require in-person or notarized documentation.
- You should not have to wait for treatment. Grantees are expected to have protocols for rapid delivery of services, including antiretrovirals, for people newly diagnosed or returning to care — services can begin before the eligibility paperwork is finished, with the formal determination following[2].
- You should not be dropped quietly. Programs should not disenroll someone until they have formally confirmed the person is no longer eligible, and self-attestation that nothing has changed is acceptable at recertification.
One rule that does shape your experience: Ryan White is the statutory payer of last resort. Its dollars cannot be used for services another payer is obligated to cover, so you may be asked to apply for Medicaid or a Marketplace plan first — Ryan White then covers what your coverage does not[1]. That is a sequencing rule, not a rejection.
The five parts: A, B, C, D, and F
HRSA organizes the program into five parts — A, B, C, D, and F. FY 2026 appropriations are below; the total, $2,571,041,000, has not changed since FY 2023[5].
| Part | Who receives the funds | What it pays for | FY 2026 |
|---|---|---|---|
| A | Eligible Metropolitan Areas and Transitional Grant Areas | Medical and support services in the hardest-hit cities and counties | $680,752,000 |
| B | 50 states, DC, Puerto Rico, the U.S. Virgin Islands, six territories | Statewide HIV care and access, including ADAP | $1,364,878,000 (ADAP non-add: $900,313,000) |
| C | Local community-based organizations | Outpatient ambulatory health services and early intervention; capacity building | $208,970,000 |
| D | Local community-based organizations | Care and support for low-income women, infants, children, and youth and their families | $77,935,000 |
| F | AETCs, dental schools and programs, SPNS and Minority AIDS Initiative recipients | Provider training, oral health care, innovative care models, minority health outcomes | AETC $34,886,000; Dental Reimbursement $13,620,000; SPNS $25,000,000 |
Recipients under Parts A through C must spend at least 75% of funds on core medical services unless that requirement is waived, and every ADAP must maintain a minimum formulary[1]. Part B grants go to each state's or territory's chief elected official, who designates the health department or another agency to run the program[4]. If you have seen “Parts A–F” written somewhere, note that HRSA's own listing has five parts, not six[6].
How to find your program and apply
Use HRSA's official locator: findhivcare.hrsa.gov, searchable by city, ZIP code, address, state, or place name[7]. Ask for the eligibility or intake worker and say you want to apply for Ryan White services; every funded site does this work every day.
Bring what you have rather than waiting until you have everything. Then ask two questions on the first visit: can I start medication today while my paperwork is processed — the answer should be yes[2] — and who is my case manager. A case manager is the difference between one application and five, and Ryan White pays for that role along with the medical care[6].
Florida: four requirements, two steps, and what to bring
Florida runs Ryan White Part B as its HIV/AIDS Patient Care Programs, through a consortia and lead-agency network covering the state's numbered HIV/AIDS service areas[8]. Florida lists four requirements: you are HIV positive; you live in Florida; you are not receiving the same services from Medicaid or insurance; and your income is at or below 400% of the federal poverty level[9]. That 400% threshold was cut in March 2026 and restored effective July 1, 2026 by the state budget signed June 29, 2026 — with a 21,000-person direct-dispense cap and no premium assistance for now[10].
What to bring. Proof of HIV status must be an original or copy of an HIV lab test — a doctor's letter will not be accepted. Also bring proof of Florida residence (photo ID if you have one), any insurance, Medicaid, or Medicare cards along with award or denial letters, and income documentation such as pay stubs, a 1040 if you are self-employed, or award and denial letters. If you are missing something, Florida DOH says bring what you have and call for help — it slows the determination rather than stopping it[9].
Two steps, in this order. First you are found eligible for HIV Patient Care Services: some forms can be completed online, you pick the county where you want services, a local lead agency contacts you and schedules an interview, and an approval letter lets you choose a case management agency (a denial comes in writing)[9]. Then you enroll in ADAP separately, using your eligibility letter, a Patient Care Core Eligibility Form, a prescription for at least one antiretroviral, and insurance documentation if it applies[11].
Call 1-800-352-2437 for the closest place to apply, or the ADAP Help Desk at 844-381-2327 to check where your application stands[11].
Related questions
Do I have to be a U.S. citizen to get Ryan White services?
No. HRSA's Policy Clarification Notice 21-02 sets exactly three eligibility factors: a documented HIV diagnosis, low income as defined by your local grantee, and residency in the grantee's service area. Citizenship and immigration status are not among them, and residency means where you live, not your legal status. HRSA also does not require in-person or notarized documentation.
What income do I have to be under?
Whatever your grantee says — there is no federal number. PCN 21-02 leaves the definition of low income to the local grantee, which may measure it as a percentage of the federal poverty level using modified adjusted gross income, adjusted gross income, individual gross income, or household gross income. Each state sets its own ADAP limit too. In Florida, the current threshold for HIV Patient Care Services and ADAP is at or below 400% FPL.
Can I start HIV medication before my paperwork is approved?
You should be able to. HRSA expects Ryan White grantees to have protocols for rapid delivery of services, including antiretrovirals, for people who are newly diagnosed or re-engaging in care, with services starting before eligibility determination is complete and the formal determination following. If a site tells you to wait weeks for medication, ask for the intake supervisor or call another funded provider.
How many parts does Ryan White have?
Five: A, B, C, D, and F. Part A funds hard-hit metropolitan areas, Part B funds states and territories and contains ADAP, Part C funds community-based outpatient early intervention care, Part D funds care for low-income women, infants, children, and youth, and Part F covers provider training, oral health, and innovation. The FY 2026 total appropriation is $2,571,041,000, unchanged since FY 2023.
Related from RiseUpToHIV
References & Sources
- KFF — The Ryan White HIV/AIDS Program: The Basics. 1990 enactment, HRSA/HAB administration, the program's size relative to Medicare and Medicaid, client income and coverage profile for 2022, the 75% core medical services requirement, and payer-of-last-resort status. ↩ ↩ ↩ ↩ ↩
- HRSA HIV/AIDS Bureau — PCN 21-02, Determining Client Eligibility & Payor of Last Resort (rev. 03/13/2025, PDF). The three eligibility factors, grantee-defined income and residency, absence of any citizenship requirement, no in-person or notarized documentation requirement, rapid service delivery including antiretrovirals, and disenrollment/recertification rules. ↩ ↩ ↩ ↩ ↩ ↩ ↩
- HRSA Ryan White — Four Years of Progress for People with HIV. More than 576,000 people served in 2023. ↩
- HRSA Ryan White — Part B: AIDS Drug Assistance Program (ADAP). State-set ADAP income limits expressed as a percentage of the federal poverty level, and Part B grants to chief elected officials who designate the administering agency. ↩ ↩
- HRSA Ryan White — Program Funding. FY 2026 appropriations by part and the $2,571,041,000 total, unchanged since FY 2023, with the ADAP non-add line of $900,313,000. ↩
- HRSA Ryan White — Program Parts and Initiatives. HRSA's own listing of five parts — A, B, C, D, and F — and what each funds, including case management and support services. ↩ ↩
- HRSA — Find a Ryan White HIV/AIDS Program Medical Provider. Official locator, searchable by city, ZIP code, address, state, or place name. ↩
- Florida Department of Health — Ryan White CARE Act Part B service areas, consortia lead agencies (PDF). Florida's consortia and lead-agency network across the state's numbered HIV/AIDS service areas. ↩
- Florida Department of Health — Eligibility information, HIV/AIDS Patient Care. Florida's four requirements including the 400% FPL threshold, the HIV lab test documentation rule, what to bring, and the county-selection, interview, and approval or denial process. ↩ ↩ ↩
- AIDS Healthcare Foundation — Florida budget becomes law, securing reversal of HIV drug cuts (June 2026). The March 2026 cut to 130% FPL, restoration of 400% FPL effective July 1, 2026 under the budget signed June 29, 2026, and the surviving 21,000-person direct-dispense cap and unrestored premium assistance. ↩
- Florida Department of Health — ADAP enrollment. ADAP as a separate second step after Patient Care eligibility, the documents required to enroll, and the ADAP Help Desk at 844-381-2327. ↩ ↩
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.