THMP – Texas Insurance Assistance Program-PLUS (TIAP-PLUS)

What is TIAP-PLUS?

The Texas HIV Medication Program (THMP) can now purchase health insurance for uninsured Texans living with HIV through a new service offering, TIAP-PLUS. Before enrolling in insurance, participants must meet THMP eligibility criteria, including income requirements.

Which health insurance plans will TIAP-PLUS cover?

To qualify for coverage under TIAP-PLUS, applicants must enroll in plans that meet the following criteria:

• Be a qualified health plan. 
• Have appropriate primary care services, including the medical location where the applicant receives HIV medical care.
• Have at least one drug in each class of core antiretroviral therapeutics from the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV.
• Include the prescription medications the applicant needs, especially those for HIV treatment.
• Include a TIAP participating pharmacy convenient to the applicant.
• Be cost-effective, as determined by THMP.

What costs will THMP cover on TIAP-PLUS?

THMP will cover the costs associated with the medication needs of the program participant. This includes the following: 

• Health insurance premiums
• Medication copayments and deductibles 

What costs will THMP not cover on TIAP-PLUS?

THMP does not cover some costs:

• Fines or tax obligations the participant may incur while participating in an Affordable Care Act (ACA) Marketplace Plan 
• Medical visit deductibles or copayments. Local Health Insurance Assistance Programs (HIA) support these costs in some local areas.
• Expenses related to inpatient hospitalization, emergency care, or any other medical services 
• Expenses for other family members or dependents on the health insurance plan
• Costs related to free-standing vision or dental plans
• Other costs outside of those outlined above under the “What costs will THMP cover on TIAP-PLUS” Section

How does an applicant apply for TIAP-PLUS?

To qualify for THMP, applicants must complete a THMP eligibility application and submit:

• Proof of an HIV diagnosis
• Proof of Texas Residency
• Proof of income, which must be at or below 200 percent of the federal poverty level 

Applicants can contact THMP at 1-800-255-1090 with questions about the TIAP-PLUS application process. Local HIV service agencies can also assist with THMP application submissions. To apply for TIAP-PLUS, an applicant must:

• Navigate to TakeChargeTexas to submit a THMP application.
• Select TIAP from the My Needs page in the TCT portal. 
• Under contact preferences, select “mail” and “phone.” THMP will need to contact the applicant during the insurance enrollment process.
• The applicant may contact THMP at 1-800-255-1090 for a paper application, if preferred. 

What are the TIAP-PLUS health insurance applicant enrollment requirements?

• Applicants must be eligible for THMP and maintain active THMP eligibility.
• Applicants must be eligible for the plan they wish to enroll in, as determined by the ACA Marketplace or other insurance plan eligibility requirements. 
• Applicants cannot select a Consolidated Omnibus Budget Reconciliation Act (COBRA) plan if they qualify for a more cost-effective health insurance plan.
• If eligible, applicants must accept the monthly Advanced Premium Tax Credit to help pay for insurance premiums.
• If applicable, the applicant must accept cost sharing reductions and enroll in a silver plan.
• The applicant must enroll in a THMP pre-approved plan or submit a different plan for THMP program approval before enrollment. If the applicant enrolls in a plan before THMP program approval, there is a chance that the plan will not qualify for THMP. 

How do I find more information on THMP?

For more information, visit the Texas HIV Medication Program.

More program information is being finalized. Updates coming soon.

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