THMP – Spend Down Discontinuation Delayed for ADAP

In the past, the Texas HIV Medication Program (THMP) applied a “spend down” equal to the cost of each participant’s yearly THMP medications. This income adjustment is for those who are over the 200% Federal Poverty Level (FPL) rule.

In December, THMP discontinued this spend down. This includes both new and renewed applications received December 1 or later.

We are delaying the elimination of the spend down for the AIDS Drug Assistance Program (ADAP) through at least June 30, 2021. THMP will review any denials based on income from December 1, 2020, forward.

If a prior applicant qualifies for the program after applying the spend down, THMP will send an approval letter. The applicant will be reinstated into the program.

THMP will process all applications for ADAP using the spend down criteria through June 30, 2021. THMP will communicate any changes between now and the end of June.

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What is the THMP spend down? 

The THMP spend down is an income adjustment for determining program eligibility. THMP calculates the adjustment as the cost equal to each participant’s yearly THMP medications. The adjustment is for those who are over the program’s 200% Federal Poverty Level (FPL) requirement.

Why did THMP eliminate the spend down?

THMP eliminated the spend down for two reasons:

  • The Health Resources Services Administration (HRSA) funds THMP. In December 2019, HRSA directed THMP to eliminate the spend down.
  • THMP identified a program deficit of $52 million for Texas’ 2021 fiscal year. Eliminating the spend down reduces program costs. This helps to continue to serve the most vulnerable.

What has changed with the elimination of the spend down?

We have not changed the program. But the delay in the spend down elimination allows you and the agencies that support you more time to find other ways to get your medications.

THMP denied my application.  What happens now?

THMP will review applications denied for being over the allowable income.  We will review applications we received between December 1, 2020, and February 10, 2021. For now, continue to seek help with your medications. Your local agency can help with this.

What if I am in the State Pharmacy Assistance Program (SPAP) or the Texas Insurance Assistance Program (TIAP)?  How does this affect me?

This change did not affect SPAP and TIAP enrollees. SPAP and TIAP have not started the spend down elimination.

How will I find out if my eligibility is getting reinstated with the ADAP program?

If you are now eligible for ADAP, THMP will send you an approval letter.