ENROLLMENT INFORMATION + APPLICATION

 

ELIGIBILITY REQUIREMENTS
To be eligible to enroll in the Massachusetts HIV Drug Assistance Program, you must:
•    Live in Massachusetts
•    Be HIV-positive
•    Meet income eligibility guidelines: A gross annual income not exceeding 500 percent of the federal poverty level ($62,450 as of January 25, 2019, with an allowance of $4,420 per dependent)

U.S. citizenship is not required.

HOW TO ENROLL
To enroll in HDAP, you need to fill out an application and submit it along with proof that you live in Massachusetts and proof of your current income (see application instructions below for details). Because HDAP is a “payer of last resort,” you will also need to submit an application to MassHealth or other insurance programs to see if you are eligible in order to enroll in HDAP. If you have a case manager, he or she can help you complete the applications.

Once you are enrolled in HDAP, you will need to recertify your information every six months to stay active in the program.

Mail your completed and signed HDAP Enrollment Application with all supporting documentation to:

Community Research Initiative of New England/HDAP
The Schrafft’s City Center
529 Main Street, Suite 301
Boston, MA 02129

or FAX the completed and signed form with all supporting documentation to 617.502.1703

Click on each image to download a PDF. The English language application is a fillable PDF, but you must first download the PDF in order to save any information that you fill in.

HDAP English Language Application

HDAP English Language Application Instructions, Client Agreement, and Grievance Procedure

HDAP Spanish Language Application

HDAP Application for Incarcerated Individuals

HDAP APPLICATION REMINDERS

  • Please fill out the application clearly and completely. We cannot process applications with incomplete or missing information.
  • Make a copy of your application for your records.
  • Once we receive your completed application materials, please allow at least two weeks for your application to be processed. You will be notified by mail of our decision.
  • All information submitted as part of your HDAP application is kept strictly confidential​​​​​​
  • Once you are enrolled in HDAP, you will need to recertify your information every six months to stay active in the program.

For more information on the status of pending applications or missing documents, please contact HDAP staff at 617.502.1700.