THMP – Frequently Asked Questions (FAQ)
What is the Texas HIV Medication Program (THMP)?
The Texas HIV Medication Program (THMP) is the government funded AIDS Drug Assistance Program (ADAP) for the State of Texas. The THMP provides certain prescription drugs to persons with HIV who meet income and residency requirements. View the THMP formulary.
Who is eligible for the THMP?
To be enrolled in the THMP, you must:
- Be diagnosed as HIV-positive;
- Be a Texas State resident;
- Meet certain income guidelines; and
- Be otherwise uninsured or underinsured for prescription drug coverage (this information must be verifiable).
What are the income guidelines?
THMP bases income qualification on your household size. Your household for eligibility determination includes only you, your spouse (whether legal or common law), and your biological, adopted, or stepchildren under age 18 that live with you.
Current income guidelines are at or below 200% of the Federal Poverty Income Guidelines (FPL). THMP will verify your income to determine your eligibility.
How do I apply to the THMP?
TakeChargeTexas (TCT) allows clients and agency workers to complete applications online for THMP and other Ryan White services. This can be completed from the comfort of home or through a local agency. Apply directly for THMP.
Call your local agency or THMP at 800-255-1090 with questions about how to apply for services.
In addition to the online application that you complete, your physician must fill out the Medical Certification Form (MCF) included in the application packet to verify your HIV status and current prescriptions. We will need documents uploaded that show your income and residency, so please collect check stubs, benefit letters, utility bills, and other documents to prepare to apply.
I submitted an application through TCT, and there were questions on there that don’t seem to relate to THMP. Why is this?
TCT provides a Universal Application for THMP and many Ryan White services provided in the state of Texas. This application asks a few additional questions so we can make sure you are assessed for eligibility for THMP and other services you may be eligible for. This reduces time you may have spent submitting multiple applications in the past.
If I am approved for the THMP, what do I need to do to stay on the program?
THMP will update or review your eligibility at least every six months after you are approved for the program. Below are your due dates, based on the month you were born:
For your update, you will need to submit a complete new application, including proof of residency and proof of income or support by the last day of your birth month every year. You will also need to submit an update form by the last day of your “half-birthday” month each year. If you enroll in TCT, you will get reminders before you due date by email, mail, or text message, which ever you select.
I heard that THMP is “payer of last resort.” What does that mean?
THMP receives federal funding through a Ryan White grant. This grant requires that services be provided to those persons who don’t have another payer, like insurance. THMP can still assist persons who have insurance or other payers, but only after other expected payments have been made and for payments that you would be expected to make yourself.
I'm currently enrolled in Medicaid in Texas. Should I still apply to the THMP?
THMP can help you if you have traditional Medicaid. THMP can provide assistance beyond the three prescriptions per month limit that may be imposed by your Medicaid plan. THMP can only assist when all three prescription slots have been used for your Medicaid plan.
I’m currently enrolled in Medicare in Texas. Should I still apply to the THMP?
Yes, the THMP program offers a State Pharmacy Assistance Program (SPAP), that assists with Medicare Part D plans for eligible persons. For more information, please visit the Medicare section.
I have health insurance. Is THMP only for people who are uninsured?
THMP has a program called the Texas Insurance Assistance Program (TIAP) that can help people with health insurance with medication copayments. TIAP can also pay COBRA premiums for qualifying plans. Please fill out the Copayment Assistance in TCT if you are interested in TIAP.
Are all the medications I need provided by this program?
Not necessarily -- the ADAP provides only antiretroviral medications and specific drugs to treat HIV-related opportunistic infections, so you may need to utilize local resources and/or the manufacturer's patient assistance programs for other medications. If you are on the SPAP or TIAP program, most of the medications your doctor prescribes will be available through the program.
I've applied and been approved for the THMP. Now how do I get my medicine?
If you were approved for the THMP ADAP, you will receive a letter in the mail that lists your assigned local pharmacy. If you would prefer to go to a different pharmacy, simply call us. We can assign you to any pharmacy on the participating pharmacy list. Each month, you will go to your pharmacy ten days before you run out of medication to request your refill. We mail your medication from the DSHS Pharmacy Warehouse, so we need time to get the medication to your pharmacy. Your pharmacy should not ask for any fees from you. If you were approved for the THMP SPAP or TIAP, you will receive an approval letter with instructions for how to order your medications with your Medicare or Private insurance.
What will be done with the information I provide?
The Texas Department of State Health Services regards all information in the application as CONFIDENTIAL. No information that could identify you will be released, except as required by the program to provide you with eligibility services and medications (for example, your doctor, agency enrollment worker, and pharmacist) or as designated by you.
I'm currently self-employed. What proof of income should I provide to the THMP?
If you are self-employed, provide a copy of your most recent signed IRS Income Tax Return. THMP can also accept a completed self-employment log. If you have questions, please call your local agency for help.
I do not have any income. What proof of income should I provide to the THMP?
If you do not have any income, please supply a Supporter Statement signed by the person who supports you (link here). If you are homeless or are supported through other community assistance, please work with your agency or shelter to get a letter that explains how you are supported.
When should I report a change to my household, marital status, income, or insurance?
Changes should be reported right away. Submit proof of the changes, such as a letter of termination, or proof that your insurance has terminated in TCT. This will help us understand your changed eligibility situation.
I received a letter stating that my application was denied due to incomplete income information, but I don't have any income to report. What do I do?
This depends on your situation. In addition to income from work, retirement, or disability, THMP will also accept bank statements for applicants who are living off of savings or rental income, child support statements, student financial aid statements, a THMP supporter statement, or a letter from a homeless shelter or community based organization explaining how you are being supported.
Why do you need to have so much documentation to prove I qualify for assistance? Why can't you just take my word on this?
THMP is funded through a federal grant, and our eligibility requirements are based on the requirements of this grant. We use the documents you provide to show you qualify for the program and information we receive through verification to show that we are only serving eligible Texans. This federal grant is what allows us to provide your medications.
What if I don’t qualify for THMP? I really need medications to take care of my health, and I can’t afford health insurance.
THMP is just one resource for your medications. Your local agency can help you with medications through resources that are available in your area or by helping you apply for a Pharmacy Assistance Program offered by pharmaceutical companies.