PrEP is covered by most insurance plans and should be covered by Medicaid and Medicare.
There are various sources of payment assistance for PrEP for people with and without insurance coverage.
If you don’t have insurance, options are available to get PrEP. The U.S. Department of Health and Human Services’ Ready, Set, PrEP Program provides PrEP at no cost for people who do not have health coverage. For more information, and to apply for the program, visit GetYourPrEP.com or call (855) 447-8410.
In addition, depending on your income, you may be eligible to get PrEP at no cost as part of a program offered by its manufacturer. Gilead’s Advancing Access Program may also be available to those on Medicare who don’t have Part D prescription drug coverage. To determine if you are eligible, your medical provider needs to submit an application for you. For more information call (800) 226-2056.
For those with insurance who need help with copay and deductible costs, Gilead’s Advancing Access Co-Pay Coupon provides up to $4,800 per year, with no monthly limit, to cover out-of-pocket expenses for PrEP, including copays, coinsurance, and deductibles. The program does not restrict benefits based on income, however it is not available for those on Medicaid, Medicare Part D or any other government prescription drug programs. For more information call (800) 226-2056.
Another option for people who get their PrEP covered by their insurance, including Medicare, is the Patient Advocate Foundation, which provides up to $7,500 per year to help pay for costs related to the prescription. Approval is based on your income. If you earn less than 400 percent of the federal poverty level (or about $48,560 for an individual with no dependents) you may qualify for this program. For more information call (866) 512-3861 and select option 1.