THMP – Texas Insurance Assistance Program (TIAP)
What is TIAP?
The Texas Department of State Health Services established TIAP in 2013 to assist eligible clients of the Texas HIV Medication Program (THMP) with paying for premiums and cost-sharing for employer-sponsored insurance coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA).
Am I eligible for TIAP?
To be eligible for TIAP, you must meet the following THMP eligibility criteria. You must:
- Receive or have received a positive HIV diagnosis.
- Live in Texas.
- Have employer-sponsored insurance or COBRA insurance.
- Receive an income that is at or below 200 percent of the Federal Poverty Level (FPL) with the standard deduction. See the table below for details.
Table: Effective Poverty Level – April 1, 2025 to March 31, 2026
Family Size | 200% FPL | Standard Deduction | Total Income | Effective FPL |
|---|---|---|---|---|
1 | $31,300 | $12,403 | $43,703 | 279.25% |
2 | $42,300 | $12,403 | $54,703 | 258.64% |
3 | $53,300 | $12,403 | $65,703 | 246.54% |
4 | $64,300 | $12,403 | $76,703 | 238.58% |
5 | $75,300 | $12,403 | $87,703 | 232.94% |
6 | $86,300 | $12,403 | $98,703 | 228.74% |
7 | $97,300 | $12,403 | $109,703 | 225.49% |
8 | $108,300 | $12,403 | $120,703 | 222.90% |
9 | $119,300 | $12,403 | $131,703 | 220.79% |
Which health insurance plans does TIAP cover?
- Employer-sponsored Insurance: TIAP will assist with employer-sponsored insurance. Your health insurance policy must cover your essential health benefits as defined by HealthCare.gov.
- COBRA Coverage: TIAP will assist with your insurance premiums and copayments only if you are already paying for your COBRA benefits.
Will THMP help me enroll in COBRA when my employer-sponsored insurance coverage expires?
If your employer-sponsored insurance coverage ends while you are still within the initial 60-day COBRA election period, the Affordable Care Act (ACA) Health Insurance Marketplace considers this a qualifying event. Therefore, THMP can help you transition to an approved ACA health insurance plan and cover your premium payments under TIAP-PLUS. Visit the TIAP-PLUS page for more information.
THMP is unable to assist you with enrolling in continued health insurance coverage under COBRA.
What if my COBRA is ending?
If your COBRA benefits expire soon, you may qualify for the ACA Marketplace special enrollment period. If you apply for an ACA Marketplace plan, THMP can help you with premium payments through TIAP-PLUS. Visit the TIAP-PLUS page for more information.
What health insurance plans does TIAP not assist with?
THMP cannot cover payments for:
- Limited liability medical plans, high-deductible health plans, Health Savings Accounts (HSAs), or health retirement accounts.
- Supplemental health insurance plans.
- Stand-alone vision or dental coverage.
What does TIAP cover?
- Health insurance premiums.
- Medication copayments.
- Medication deductibles.
What does TIAP not cover?
THMP does not cover medical visit deductibles, copayments, or any other costs related to your insurance plan not included above.
Some local HIV service agencies have health insurance assistance programs that can cover these costs. You can find HIV service providers in your area by visiting the list of providers in Texas.
How do I apply for TIAP?
You can visit your local HIV service provider for in-person help with the TIAP application. You can also contact THMP at 800-255-1090, option 4, and then option 2 for help.
If you prefer to enroll in TIAP on your own, you can visit TakeChargeTexas and fill out the online THMP application. During the THMP application process, make sure you select “TIAP” on the My Needs page.
If you have already enrolled in TIAP, please keep in mind that you will need to:
- Contact THMP if your employment ends or changes.
- Contact THMP if your insurance benefits change.
- Find an in-network pharmacy near you, visit Ramsell:
- Find the Pharmacy Locator on the left-hand side of the screen.
- Enter your city, ZIP code, or county.
- Click “Locate.”
- Make sure the pharmacy you choose is also in-network with your primary insurance.
- Present your Ramsell Copay Card along with your insurance card when filling prescriptions at a Ramsell-participating pharmacy. You will not owe any money when picking up your prescriptions.
You must fill and process your medication prescription through a Ramsell-participating pharmacy with both your private insurance and Ramsell copay cards. Ramsell participants may not use patient assistance cards (including e-vouchers) for medications covered by TIAP. TIAP coverage includes medications for both HIV treatment and other prescriptions covered under your insurance plan. Make sure you use both cards at a Ramsell-participating pharmacy to stay enrolled in TIAP.
Need more help?
If you need help finding an in-network participating pharmacy that will work with your insurance, contact Ramsell at 888-311-7632. You can also visit the Ramsell website and submit a request assistance form.
For other questions, visit your local HIV service agency for in-person assistance. You can also contact THMP at 800-255-1090, option 4, then option 2.
Note for Administrative Agency Enrollment Workers (AEWs): Ramsell Corporation makes medication copayments for eligible THMP enrollees. To maintain Ryan White payer of last resort requirements, administrative agencies must coordinate with THMP since THMP is the last payer. Please help clients enroll in a local health insurance assistance (HIA) program to cover medical out-of-pocket expenses not covered by THMP.