Benefits and Eligibility
For persons who are unable to secure health insurance outside of an open enrollment period, CAREAssist can assist with payments for a limited number of medical services and medications necessary for HIV treatment, through the
Uninsured Persons Program (UPP).
Benefits include:
-
Formulary medications when dispensed at a CAREAssist in-network pharmacy -
Limited laboratory and medical services performed in an out-patient setting, necessary for engagement in HIV treatment. Payment is based on 125% of the current OHP Fee-For-Service rate. Any additional payment occurrence for CPT codes requires prior authorization.
- Medication Therapy Management
- Tobacco Cessation Services
Eligibility Requirements
- Must submit a complete CAREAssist application, verifying HIV/AIDS status, income at or below 550% of the Federal Poverty Level, and Oregon residency.
- Must be ineligible for health insurance. Program must be notified if and when insurance becomes available.
- Must be enrolled in community-based Ryan White HIV Case Management services.
- Must maintain all other program requirements, such as completion of the Client Eligibility Review.
If you have questions about the Uninsured Persons Program, please contact the
CAREAssist program.