Eligibility/Service Fees

• Diagnosed with HIV/AIDS
• 18 years of age or older
• Medicare/Medicaid accepted
• Most Insurance Plans
• Assistance is available based on the patient's income

Ryan White Part C or D Eligibility Check List

1. Patient must have diagnosis of HIV/AIDS and be 18 years of age or older.
2. Patient must complete Ryan White Part C or D Eligibility application and provide proof of income (*as defined below). Patient must provide documentation of any income including but not limited to the following; Social Security (SSI, SSD, etc.), Employment, Child Support, Unemployment Compensation, Workers Compensation, Alimony, Retirement, Other Federal or State Assistance.  Income must include all household income. 
3. Patient must have exhausted all other payors including but not limited to the following; Medicaid and Medicare.
4. Patient eligibility is then determined by the Program Director according to percentage of income compared to Federal Poverty Guidelines (FPG) for the given year.  The eligibility will be considered from January 1 through December 31. Patients may be charged a percentage of their income for HIV related services based on the FPG.
5. Ryan White Part C or D funds can assist with medications, dental and health care expenses as defined in the policy and procedure manual. 

*Proof of income can be defined as one of the following documents:

• Award Letter (from social security, alimony, unemployment, etc.)
• Bank statement showing direct deposit
• Pay stubs (from any type of income)
• Written statement of no income
• Tax Returns from previous year

Source of Funding:

Funding for the Ryan White Part C Early Intervention Services Program is provided by HRSA Grant # H76HA01719.

Funding for the Ryan White Part D Women and Youth Program is provided by HRSA Grant #H12HA24866