6/15
First, call your primary care doctor or case manager.
Have insurance?
Call the number on your insurance card.
Have Medicaid Managed Care?
For a list of covered medications visit:
pbic.nysdoh.suny.edu/
Have ADAP?
Call: 1-800-542-2437
Still have trouble getting your medications?
Email: [email protected]
For general information call:
1-800-541-2437 (English); 1-800-233-7432 (Español)
0165
If any of your personal information or medications
on this card change, please destroy this card.
Call 877-874-0776 to obtain a new card.
6/15
Tips for
getting your
medications
Ensure you have enough medications before leaving, until
you can get to a pharmacy.
Before leaving, review your entire medication list with your
doctor(s) and bring it to your next medical appointment.
Tell your primary care doctor you’re in the hospital.
Before taking any HIV medication substitutions, first discuss
with your doctor.
Give a copy of your current medication list to your doctor(s).
Don’t have your current medications? Ask a trusted person
to bring them to the hospital for you.
Bring all current medications you are taking to the hospital.
If you are in the hospital:
If any of your personal information or medications
on this card change, please destroy this card.
Call 877-874-0776 to obtain a new card.
0165
Dosage
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Name
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
Ask your doctor to give you an up-to-date list after
each visit or fill in up-to-date medications below.
Keep with you at all times.
List your current medications:
Phone ________________________________
Name ________________________________
Case Manager/Social Worker
Phone ________________________________
Name ________________________________
Pharmacy
Phone ________________________________
Name ________________________________
Doctor
Phone ________________________________
Name ________________________________
Emergency Contact
Date of Birth ___________________________
Name ________________________________
Keep this information on you at all times