PrEP care includes paying the costs or co-pays for your medical visits, lab work, and prescription pick-up. Depending on your health plan or medical care, your out-of-pocket costs will vary.
Most insurance plans cover PrEP, including commercial and employer plans, Medicaid, Medicare, the VA, and TRICARE. Uninsured people can also get PrEP through various state and federal assistance programs. Often, staff (including PrEP navigators) at public and other medical clinics and telehealth services can help you apply for programs to cover some or all of your PrEP care costs. Consult your health plan or with your healthcare provider’s office for how much your co-pays will be for PrEP.
If you live in the San Francisco Bay Area and need information about affording PrEP, contact our PrEP & HIV Benefits & Navigation team, at firstname.lastname@example.org.
The cost calculator at PrEPcost.org is a helpful tool. By plugging in some basic information anonymously on the form, you get a snapshot of possible monthly and yearly PrEP costs with various health plans in your state. If it looks like you might need help paying some of those costs, consider applying at the assistance programs listed below.
PrEP assistance programs
Various assistance programs are available to help pay certain PrEP costs. Eligibility is based on income limits and types of health insurance.
State PrEP Assistance programs
Ready, Set, PrEP
The Ready, Set, PrEP is a federal program that makes PrEP medication available at no cost for qualifying recipients.
Gilead Advancing Access Patient Support program
The Advancing Access Patient Support program covers cost of prescription (uninsured, insurer denies prescription, Medicare without Part D). The Copay Coupon program covers prescription copays (up to $7,200 assistance, commercially insured, no income limit)
Co-pay Relief program (CPR)
CPR provides direct financial assistance with co-payments, co-insurance and deductibles required by the patient’s insurer for medications prescribed to treat and manage their disease.
Pan Foundation HIV Treatment and Prevention
Covers prescription copays, up to $3,400 assistance, single income below $63,800, Medicare only–often closed to new enrollment.
Good Days HIV, AIDS Treatment & Prevention
Covers prescription copays, up to $7,500 assistance, single income below $63,800; Medicare, TRICARE, CHAMPVA, and BC/BS Federal only.
PrEP Facts content written by Alan McCord and Reilly O’Neal. Medical review by Janessa Broussard, RN, MSN, AGNP-C, vice president of medical affairs at San Francisco AIDS Foundation.