ADAP Resources

ADAP Co​ntact sheets

• OA-HIPP Advisor Roster - Advisor assignments and contact information organized by health plan.
• ADAP Advisor Enrollment Site Assignments - Advisor assignments organized by county and enrollment site.
• ​ADAP Enrollment Site Locator
• ​​ADAP & Certified Covered California Enrollment Site List
  

ADAP Documents

• Blank Supporting Documents (PDF) 

ADAP Formulary

• ADAP Formulary
  

Reference Guides

• Acceptable Supporting Documentation​
• Acceptable Supporting Docu​mentation (Spanish)
• OA-HIPP Medical Out-of-Pocket Guide (EW version) (PDF)
• OA-HIPP Medical Out-of-Pocket Guide (Client version) (PDF)
• Federal Poverty Guidelines Chart
  
• ADAP Folder ​Requirements (PDF) 
  
• Instructions for Submitting Documents to ADAP
• Enrollment Site Fee Schedule (PDF)​
• MPPP Medical-Out-of-Pocket Guide (EW version)​
• ADAP Client Brochure (PDF) 
  
• ADAP Client Brochure (Spanish) (PDF)​
  
• EB-HIPP Client Checklist
  
• EB-HIPP Client Checklist (Spanish)
  
• EB-HIPP Client FAQ
  
• EB-HIPP Client FAQ (Spanish)​
  
• An Explanation of the Medical Out-of-Pocket (MOOP) Benefit - A Guide for Clients (PDF)
• An Explanation of the Medical Out-of-Pocket (MOOP) Benefit - A Guide for Providers (PDF) 
  
• Spousal/Dependent Medical-Out-of-Pocket (MOOP) Benefit - FAQ for Enrollment Workers​
  

ADAP Allowable Servi​​ces

• ADAP Allowable Medical Services - Cabenuva
  
• ADAP Allowable Clinically Administered Medications - Cabenuva​
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