Before you can start taking the daily PrEP pill for HIV prevention, you're going to want to make sure you can cover all the costs.
Most insurance plans and many Medicaid plans do cover PrEP, but there still may be some out of pocket co-pays you could be responsible for. That means you're going to need to do a little research before you get started so you can find out for sure what is and isn't covered. Nobody wants surprise medical bills, so do your homework.
Some insurance companies will cover PrEP, no questions asked, but others may require a little more work on your part to get them to pay up.
In some cases your doctor may also have to submit paperwork to your insurance company for "prior authorization" (PA) before prescribing you PrEP. There are specific diagnosis codes doctors have to give insurance companies to get PrEP approved for you--if they don't know the right codes, you can help them find them here on PAGE 29.
The good news is that even if you have co-pays, there's free financial aid out there to help you out with those payments.
Gilead Pharmaceuticals, the company that makes the PrEP pill (Truvada), offers co-pay financial assistance to those who qualify. You can call Gilead's Advancing Access Hotline at 1-800-226-2056 for more information about getting co-pay assistance. If your insurance doesn't accept the Gilead co-pay card, you can still get reimbursed for your expenses through a mail in rebate program.
There are also several other non-profit health organizations that offer money to help out with costs for PrEP that insurance doesn’t cover.
With any of the available PrEP assistance programs, make sure you apply for them BEFORE you try and get your prescription filled.
The tool below is a good place to start to learn about available financial assistance to pay for PrEP.
*Your privacy is important to us. We DO NOT store or record any information that you enter in any of the online tools on this website. No one sees it but you!
Before checking out these links, use the Paying 4 PrEP tool above to find out which of the below programs you may be eligible for.
If your insurance doesn't accept the Gilead co-pay card, you should still be able to get reimbursed for some or all of your copay expenses through a mail in rebate program. You have to have your Gilead co-pay card activated before you fill the prescription. You can find the mail-in rebate form here https://www.patientrebateonline.com.