Covering the Costs of PrEP and PEP
Paying for PrEP
Most health plans cover most PrEP care costs. For many people, it’s as routine as paying for any other prescription. However, if you cannot afford your out-of-pocket costs or are uninsured, the patient assistance programs below could help. Each program uses the Federal Poverty Level (FPL) to determine a person’s income.
Your Guide to HIV PrEP Coverage and Insurance Rights
An expanded guide to understanding HIV PrEP coverage and your rights.
NeedyMeds
NeedyMeds is a 501(c)(3) national non-profit that connects people to programs that will help them afford their medications and other healthcare costs.
Gilead Advancing Access Copay Coupon Program
- Provides up to $7,200 per year for prescription copays
- Any income level is eligible, no lifetime limit
- Resident of the U.S. or its territories; SSN not required
- Must be commercially insured, or have Medicare with no Part D benefits
- This program does not use public charge as an eligibility determination
State PrEP Assistance Programs
NASTAD maintains a list of PrEP assistance programs in a variety of states.
USPHS – 2021 PrEP Guidelines, Clinical Providers’ Supplement
The clinical providers' supplement to the 2021 PrEP guidelines from the USPHS (United States Public Health Service).
Gilead Advancing Access Patient Support Program (Oral PrEP)
- Covers cost of Truvada or Descovy
- Income at or below 500% FPL but above 138% FPL (Medicaid eligible)
- Resident of the U.S. or its territories; SSN not required; undocumented residents eligible
- Must be uninsured, insurance denies coverage, or have Medicare with no Part D benefits
- This program does not use public charge as an eligibility determination
EBGTZ – Same-day Oral PrEP Guide
A same-day oral PrEP guide from East Bay Getting to Zero.
Covering Costs of PrEP Job Aid
Tips and Resources for Covering Costs of HIV PrEP from HealthHIV.
Patient Advocate Foundation Co-Pay Relief
Patient Advocate Foundation (PAF) is a national 501 (c)(3) non-profit organization which provides case management services and financial aid to Americans with chronic, life threatening and debilitating illnesses.
- Provides up to $7,500 per year for prescription copays
- Income at or below 400% FPL plus cost of living index
- U.S. resident; SSN or alien registration number required
- Must have health insurance (includes Medicare)
- This program does not use public charge as an eligibility determination
NASTAD – Billing and Coding Guides for HIV Prevention
Billing and coding guides for HIV prevention from NASTAD (the National Alliance of State and Territorial AIDS Directors).
DOL, HHS, and UST – FAQs About the Affordable Care Act Implementation
FAQs regarding the Affordable Care Act's implementation from the US Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (UST).
CMS – Covering HIV PrEP Under Medicare
FAQs regarding covering HIV PrEP under Medicare from CMS (the Centers for Medicare and Medicaid Services).