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Insurers must cover injectable HIV prevention drug — unless courts void mandate
Insurers must cover injectable HIV prevention drug — unless courts void mandate
March 22, 2024
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Answer Summary

Members strongly agreed that health insurance should fully cover HIV PrEP to help cut the spread of HIV, with many pointing out that despite... Read more

Members strongly agreed that health insurance should fully cover HIV PrEP to help cut the spread of HIV, with many pointing out that despite current coverage options, barriers still exist for those who must qualify for assistance programs or face high costs. Several members shared practical information about existing resources, including the CDC's Ready, Set, PrEP program, co-pay assistance options, and state-specific programs, while noting that a 2025 mandate to make PrEP free suggests current coverage is incomplete. A recurring theme was frustration with pharmaceutical companies prioritizing profitable HIV treatment medications over prevention, the need for more public awareness through advertising, and admiration for countries like Canada and the UK where preventive care is fully covered without cost barriers.

A myHIVteam Member

Most insurance plans and state Medicaid programs cover PrEP. Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. That means you can’t be charged for your PrEP medication or the clinic visits and lab tests you need to maintain your prescription.

If you don’t have insurance or Medicaid coverage, there are other programs that provide PrEP for free or at a reduced cost:

Ready, Set, PrEP makes PrEP medication available at no cost to those who qualify.
Co-pay assistance programs help lower the costs of PrEP medications. Income is not a factor in eligibility.
ViiVConnect offers a program to help pay for PrEP shots.
Some states have PrEP assistance programs. Some programs cover PrEP medication, while others cover clinical visits and lab tests. Some programs cover both.
Select an answer below to find out how you can pay for PrEP.
This information is located on the cdc website.

March 22, 2024
A myHIVteam Member

Mark7777 so true America is such a powerful country but for some reason we let pharmaceutical companies decide are fate

March 23, 2024
A myHIVteam Member

Absolutely

March 23, 2024
A myHIVteam Member

Yes of course...would be smartest move...but nobody said those in charge think outside of box...in canada all covered, thank god..only makes sence to do

March 23, 2024
A myHIVteam Member

Absolutely !! plus it would be nice to see more commercials on tv. For prep . For every one prep commercial theres 10 biktarvy and dovoto commercials . Seems like there’s more incentive from the drug companies to push HIV meds to control HIV then prevent it

March 23, 2024

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