TBDAP FAQS

Tuberculosis Drug Assistance Program (TBDAP): Frequently Asked Questions

How does TBDAP work?

  • When patients are identified by designated TB outpatient services providers and prescribed TB medicines, they are directed to designated pharmacies where they can pick up their TB-related medicines at no cost.
  • TBDAP is a program of the Massachusetts Department of Public Health (MDPH) that is administered by Community Research Initiative (CRI).

Who is eligible for TBDAP?

  • Anyone living in Massachusetts who is being treated for diagnosed or suspected latent TB infection or active TB is eligible.
  • Patients do not have to complete an application or fulfill any eligibility criteria (such as income level or immigration status). U.S. citizenship is not required to access the program.

What if the patient has insurance?

  • Insurance will be billed first for TB medicines. Out-of-pocket expenses (co-pays, deductibles, etc.) and prescriptions that are not covered by insurance will be covered by TBDAP. The patient does not pay for TB medicines.
  • Insured patients will need to provide health insurance information to their TB outpatient services provider and pharmacy.

What if the patient does not have insurance?

  • TBDAP will cover the full cost of all TB-related prescriptions.

What does the patient do when they go to the pharmacy?

  • The prescriber may give the patient a TBDAP card or ticket, which they will bring to the pharmacy.
  • The patient will pick up their medicines at the designated pharmacy for TB outpatient services.
  • The pharmacy will provide the patient with medicine and will require no payment at the time of pick-up.
  • The pharmacy will provide CRI/TBDAP with the patient information necessary to enroll the patient in TBDAP and receive a TBDAP ID number.

What if the patient’s insurance requires prior authorization for a medicine?

  • The prescriber should submit the prior authorization request as per the insurer’s requirements and the clinical site’s usual procedures.
  • If medically necessary, TBDAP will cover the cost of the medicine while the prior authorization request application and approval are pending.
  • When the prior authorization request has been approved, the prescriber should notify their TBDAP pharmacist as soon as possible.

What if the patient’s insurance has a 90-day prescription-fill requirement?

  • If a waiver or exception is not available from the insurer, TBDAP can cover the full cost of medicines.
  • The provider should contact CRI/TBDAP staff and their TBDAP pharmacist to request full coverage.

What if the patient has an urgent, time-sensitive, or travel-related medicine need?

  • Please contact CRI/TBDAP staff as soon as possible.
  • For travel requests, all sites should refer to the TBDAP Vacation Fill Requests document for guidance.

What if the patient is co-infected with HIV?

  • For patients already enrolled in the HIV Drug Assistance Program (HDAP), TB medications are to be billed through HDAP. Patients who wish to enroll in HDAP or find more information can do so at: crine.org/hdap.
  • TBDAP cannot cover the cost of any medication outside of the TBDAP formulary, including HIV medication.

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