How to Pay for PrEP

How to Pay for PrEP

So you’re thinking of taking PrEP (a.k.a. pre-exposure prophylaxis). You’ve already learned how PrEP can prevent HIV infection and have explored the different types of PrEP. Now you’re ready to dive in and figure out how to pay for PrEP. The answer will depend on whether or not you have health insurance (and there are options if you don’t). Click the button below that describes your situation to learn more.

The good news is that, under the Affordable Care Act, PrEP must be free under almost all health insurance plans. This includes medication, office visits, and the lab tests needed to maintain your prescription. As with any type of health care you receive, you’ll want to check your specific plan and verify your coverage and see which type of PrEP you plan covers with no cost.

  • If you have a plan from the healthcare.gov marketplace, you can check your coverage here. If you need help, this document walks you through the process step by step.
  • If you have private insurance or a plan provided by your provider, check directly with your plan/provider.
  • Medicare Part B covers PrEP medication and related services, if you’re eligible. 
  • If you have Medicaid, check with your benefits counselor about PrEP coverage. Most states offer coverage through their basic health plans.

If you have some coverage but still need assistance paying for PrEP, there are some programs that may help. Each will have some limitations and requirements to qualify.

From Drug Manufacturers

  • The Gilead Advancing Access Co-Pay Savings Program offers assistance paying for out-of-pocket costs for people with commercial or private insurance. It is not available for people using Medicare, Medicaid, Federal Employees Health Benefits Program, or VA/TRICARE. The program provides up to $8,000 in cost-sharing assistance per calendar year, including up to $100 per visit for injection administration, for Yetzugo or up to $7,200 in cost-sharing assistance per calendar year for Descovy or Truvada. Learn more at the Gilead website or by calling 1-800-226-2056.
  • LIke the Gilead program, the ViiV Injectables Savings Program is available for people who have commercial health insurance but not for those with Medicare, Medicaid, Veterans Affairs, or TRICARE plans. It provides help with out-of-pocket costs for its injectible PrEP option, Apretude, as medicine, as well as deductibles and co-pays. Patients can enroll online or call 1-844-588-3288 for more information.

Other Programs

  • The Patient Advocate Foundation TotalAssist Program is a charitable patient financial assistance program. You can check your eligibility and apply for a TotalAssist grant here.
  • Some states have PrEP assistance programs that offer assistance paying for medication, lab, and office visits. Learn more here.

If you don’t have health insurance, there are resources available and programs that may allow you to get PrEP for free. These programs typically have certain requirements (like an income below a certain level) to qualify.

PrEP Locator

The PrEP locator is a great place to start to find care. This online tool lets you search and find PrEP providers near to you. There are options to narrow your search to find only providers who prescribe PrEP for patients without insurance. Additionally, you can search for clinics that have a PrEP navigator on staff. PrEP navigators are specialized staff who can help patients with insurance enrollment, financial co-pay assistance programs, and setting up needed medical appointments. 

Find a Low-Cost Clinic

The Health Resources and Services Administration (HRSA) funds community health centers across the country that provider care regardless of your ability to pay. You can search here for a clinic with sliding scale fees to help cover
costs of clinical visits and lab tests.

Drug Manufacturer Programs