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ADAP Assist Prescription Benefit Manager FAQ Guide
Who is Ramsell?
Ramsell Corporation is a pharmacy benefit manager (PBM), which means they assist in
processing prescription drug claims. They are experienced in serving people living with
HIV/AIDS and work with ADAPs throughout the United States.

Who do these changes impact?
These changes will only affect ADAP clients who have private insurance, Medicare or PCIP
(Pre-Existing Condition Insurance Plan) coverage. ADAP clients not on ADAP Assist will still
be required to fill through Avella Specialty Pharmacy.

What pharmacies can I use?
ADAP Assist clients may choose to continue to use Avella Specialty Pharmacy (formerly The
Apothecary Shops) at (866) 881-4902 oreach time they need a refill. You may
also contact Ramsell or visit Ramsell’s website aafter December 19,
2012 to find other pharmacies that you can use.
I don’t see the pharmacy I want to use as an option. Will there be more added?
Yes. Pharmacy choices will be available on Ramsell’s website starting December 19th, 2012.
These choices should include several popular pharmacies and independent pharmacies. We
anticipate more to be added in March 2013.
How do I use this card?
ADAP Assist clients will show their prescription card to the pharmacist when filling their
prescription. It gives important information about ADAP Assist eligibility. Pharmacists will
connect with Ramsell by computer to check eligibility and get approval to fill prescriptions.

Do I need a copy of my prescriptions from my doctor?
Yes. Clients on ADAP Assist are now responsible for ensuring their pharmacy of choice
receives their prescriptions. Clients on ADAP Assist may have their physician fax their
prescriptions to the pharmacy of choice or provide the original signed page 5 from the ADAP
application to their pharmacy. ADAP will fax prescriptions to Avella Specialty Pharmacy for
ADAP Assist clients upon request.
What will these changes cost me?
The copays for your medications will still be fully covered through ADAP. There are no
increased costs to you.
Do I still need to complete my ADAP renewal?
Yes. These changes will not affect the 6 month and 2 year ADAP renewal process.
What medications can I fill through ADAP Assist?
ADAP Assist covers all copays for medications on the ADAP formulary as well as additional
medications approved under the primary insurance’s formulary.
Are there certain medications that ADAP Assist does not cover?
ADAP Assist cannot pay copays for the following medication categories:

Are there certain medications that require prior authorization?
Some medications available through ADAP Assist require prior authorization. The forms for
prior authorization can be found a following
medications require prior authorization:

Can I continue to use mail order options?
Yes. Clients on ADAP Assist may elect to remain with Avella Specialty pharmacy to have their
medications shipped to them at no cost, or may choose another pharmacy to deliver their
medications at their own expense.
Can I get a 90 day supply?
No. Due to federal regulations, clients on ADAP Assist can still only receive 1 month of
medication at a time.

I have PCIP coverage. Does this affect my medical benefits?
No. ADAP will continue to pay your PCIP premiums and medical co-pays. Please continue to
work with Kelly Morrow and Neil MacDonald at SAAF (520-628-7223) for your medical bill
submissions. The card you will receive in the mail from Ramsell DOES NOT replace your PCIP
card.
I know someone on the regular ADAP program. Will they be able to participate?
No. Clients on traditional ADAP are still required to fill their medications through Avella
Specialty Pharmacy.

Why are things changing?
We feel this will provide more options in meeting the medication needs of our ADAP Assist
clients. Using a prescription benefit manager (PBM) also allows ADAP to accurately report True
Out of Pocket (TrOOP) costs for our Medicare clients. Several ADAP Assist clients are finding
their private insurance companies restrict where medications can be filled. Using a PBM allows
for greater flexibility in working with private insurance companies.
What if I have additional questions?
If you have any further questions or concerns about the ADAP Assist Program or Ramsell, you
may call us at (800) 334-1540 or (602) 364-3610. Please ask to speak to the ADAP coordinator.

Source: http://www.hivaz.org/sites/default/files/pbm_faq.pdf

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