Insurance and Copay Assistance for PrEP

Will My Insurance Pay for PrEP?

If you have insurance, your pre-exposure prophylaxis (PrEP) prescription should be covered. You will only need to worry about copays or, depending on your plan, deductibles. However, when starting any new medication, it is a good idea to contact your insurance company and verify your coverage. 

Gilead, the maker of Truvada, has copay assistance that makes getting on Truvada PrEP, the HIV prevention pill, extremely affordable for almost anyone. Many patients pay nothing out of pocket for PrEP.

PrEP Drug Insurance and Copay Assistance

Insurance plans typically cover PrEP costs via Pharmacy Benefits. Considering that the PrEP prevention pill can cost up to $20,000 a year, this can help PrEP users save a significant amount of money.

If you book an appointment with a PlushCare doctor to discuss the PrEP drug, you will learn how much insurance will cover before you commit to a treatment regimen.

PlushCare also provides each patient with a PrEP Coordinator who will guide you through the payment process and check if you are eligible for assistance programs.

Buyer beware: sometimes you will be billed due to a high deductible. Make sure to check with your PrEP provider to confirm that your insurance company has been billed properly.

PlushCare has had patients on the PrEP drug covered by the following insurance plans and more:

• Blue Cross Blue Shield
• Blue Shield of California
• Anthem Blue Cross
• Aetna
• Humana
• Molina
• Delta Health
• Marketplace plans
• IEHP
• Healthnet
• TriCare
• Highmark
• Coventry
• Oxford
• Carefirst
• Medi-Cal
• Medicare

In 2014, California started covering PrEP costs via the state’s Medicaid program, Medi-Cal. California continues to lead the way in making PrEP accessible as the California Department of Public Health (CDPH) has partnered with PlushCare to provide free access to PrEP statewide.

Today, “most insurance plans and state Medicaid programs cover PrEP,” according to the United States Centers for Disease Control and Prevention. “There are also other programs that provide PrEP for free or at a reduced cost,” such as Ready, Set, PrEP, which makes the HIV prevention drug available at no cost to eligible patients.

How to Get PrEP Without Insurance

You can absolutely get PrEP without insurance. If you are uninsured, the best route to getting PrEP is to visit Gilead’s Advancing Access website and fill out a quick form to better understand your options.

If you do not have insurance but think you would make a strong PrEP candidate, locate a community health center near you to learn more about available assistance programs. 

Alternatively, you can book an appointment with us to meet with one of our board-certified doctors on your phone and discuss your PrEP treatment options. We accept uninsured and self-pay members for a first visit cost of $129 and follow-up visit cost of $69. If one of our experienced doctors cannot help you, you will get your money back.

Gilead Assistance for Truvada Costs

Gilead is the company that makes the brand-name PrEP drug, Truvada.

Gilead has a Copay Assistance Program that can be used in conjunction with private insurance to offset the price recommended for all privately insured patients, to help offset a high deductible, or to simply offset the copay costs.

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Read: Easy, Safe, Secure STD Testing Online

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How Does Gilead Copay Assistance for Truvada PrEP Work?

Gilead requires the following stipulations be met to be eligible for Truvada PreP copay assistance:

• Negative results on an HIV test taken within 90 days of the prescription.
• Proof of U.S. residency (bank statements, utility bills, and other documents that have your name and U.S. address).
• Proof of income that shows you are under 500 percent of the poverty line in your area.

Once you have found a healthcare provider willing to prescribe the PrEP drug, you can enroll in the assistance program by mail or online.

Find Affordable PrEP Treatment

Starting the HIV prevention pill can be expensive, but there are ways to make PrEP costs more affordable. Between your insurance and Gilead’s copay assistance, you should be paying very little for PrEP.

Click here to book a PrEP consultation on your phone. 

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Read More About PrEP

• How to Get PrEP Online
• Descovy Prescription Online
• Truvada Prescription Online
• Top 3 Reasons to Get on PrEP

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