The purpose of the Community Resource Initiative Tuberculosis Drug Assistance Program (TDAP) is to ensure that clinicians and patients can access the Tuberculosis medications they need in a timely and cost-effective manner. TDAP utilizes designated pharmacies located at or near Tuberculosis clinic sites for patients to pick up their prescriptions. TDAP is a program of the Massachusetts Department of Public Health Office of HIV/AIDS, Bureau of Infectious Disease and Laboratory Sciences.
Community Resource Initiative’s Tuberculosis Drug Assistance Program:
- Increases access and adherence to Tuberculosis treatment by covering out of pocket and full costs for Tuberculosis medications;
- Reduces or eliminates barriers for patients to obtain Tuberculosis medications by partnering with clinical sites and knowledgeable and convenient pharmacies;
- Increases the capacity of the state’s Tuberculosis program to direct public health resources where they are most needed by maximizing use of health insurance coverage.
Eligibility
- Any individual being treated at a state-funded outpatient Tuberculosis clinic or collaborating health care site in Massachusetts is eligible to have the cost of their Tuberculosis prescriptions covered by TDAP.
- There is no enrollment application and patients do not need to fulfill any eligibility criteria (such as an income level).
- U.S. citizenship is not required to access the program.
- TB patients who have health insurance will need to provide information about their health insurance plan to their TB clinical site and pharmacy.
Frequently Asked Questions
- When patients are identified by designated outpatient Tuberculosis service providers, they are directed to designated pharmacies where they can pick up their Tuberculosis-related medicines at no cost.
- Participating pharmacies bill insurance first for Tuberculosis medicines and then Community Resource Initiative for out-of-pocket expenses and Tuberculosis-related medications that are not covered by insurance, or the full cost of the medication if the client is uninsured. The patient does not pay for Tuberculosis medicines.
TDAP is a program of the Massachusetts Department of Public Health (MDPH) that is administered by Community Resource Initiative.
Any individual being treated at a state-funded outpatient Tuberculosis clinic or collaborating health care site in Massachusetts is eligible to have the cost of their Tuberculosis prescriptions covered by TDAP.
- There is no enrollment application and patients do not need to fulfill any eligibility criteria (such as an income level).
- U.S. citizenship is not required to access the program.
- Tuberculosis patients who have health insurance will need to provide information about their health insurance plan to their Tuberculosis clinical site and pharmacy.
Insured patients will need to provide health insurance information to their Tuberculosis provider and pharmacy.
TDAP will cover the full cost of all Tuberculosis-related medications.
- The prescriber may give the patient a TDAP card or ticket, which they will bring to the pharmacy.
- The prescriber may also work directly with the pharmacy to identify Tuberculosis patients.
- The patient will pick up their medications at the designated pharmacy.
- The pharmacy will provide the patient with their prescriptions and will require no payment at the time of pick-up.
- The pharmacy and Community Resource Initiative coordinates on payment.
- The prescriber should submit the prior authorization request as per the insurer’s requirements and the clinical site’s usual procedures.
- If medically necessary as part of the patient’s Tuberculosis regimen, TDAP will cover the cost of the medicine while the prior authorization request application and approval are pending.
- When the prior authorization request has been approved, the prescriber should notify their pharmacist as soon as possible.
If a waiver or exception is not available from the insurer, TDAP can cover the full cost of Tuberculosis medications.
- Please alert the pharmacist, who will contact Community Resource Initiative’s TDAP staff as soon as possible.
- All sites should contact Community Resource Initiative for early refills or override guidance.
- For patients who are already enrolled in the HIV Drug Assistance Program (HDAP), Tuberculosis medications are covered by HDAP. For more information or to enroll in HDAP, click here.
- TDAP cannot cover HIV medications or the cost of any medications not related to Tuberculosis treatment.
Important Notice
As of July 1, 2022, all TDAP claims for eligible insured and uninsured clients will be processed through Community Resource Initiative’s new PBM, Magellan Rx (MRx).
Please visit MRx’s Provider Portal for billing instructions and additional information.
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