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Ryan White Program Coverage

Ryan White Grant Coverage Terms

  • Ryan White is the payer of last resort
    • Payer of Last Resort Requirement
      • CARE Act grant funds cannot be used to make payments for any item or service if payment has been made, or can reasonably be expected to be made, with respect to that item or service, under any State compensation program, under any insurance policy, or under any Federal or State health benefits program; or by an entity that provides prepaid healthcare.
  • Coverage is one year and then re-evaluated at that time
  • If you receive a bill, please let one of the SWs know so that we can reconcile any discrepancies

What the Ryan White Grant Does Not Cover

  • The Ryan White Grant does not cover inpatient or ER costs ever.
  • The Ryan White Grant does not cover any other specialty service that has not been referred by their HIV Primary Care MD
  • The Ryan White Grant does not cover all non-HIV related medication and are addressed on a case-by-case basis
  • Other specialty procedures are evaluated on a case-by-case basis and are referred to EUHM Charity Care Program

Termination from the Ryan White Program

  • Failure to report third-party coverage
  • Receiving primary care HIV services from another program/ agency/ MD office
  • Exceeding the income requirements
  • Living outside the service area