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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.

State PrEP Assistance Programs

NASTAD maintains a list of PrEP assistance programs in a variety of states.

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

Apretude Insurance Flowsheet

Insurance flowsheet compiled by East Bay Getting to Zero on covering costs of cabotegravir for PrEP through insurance in the San Francisco Bay Area. This flowsheet resource may serve as a model for other regions.

ViiVConnect Savings Program (Injectable PrEP)

  • Covers cost of Apretude and injection support services
  • Copay assistance: no income limit;
    Medication assistance: income at or below 500% FPL
  • Copay assistance: commercial insurance;
    Medication assistance: ineligible for Medicaid/Mi Salud Health AND no prescription drug coverage OR have a Medicare Part B or D or Advantage Plan OR limited commercial insurance plan
  • Resident of the U.S. or its territories; Social Security Number (SSN) not required
  • Check to see if ViiVConnect is used as a determination for public charge

CoverMyMeds.com

CoverMyMeds solves medication access challenges for patients throughout every step of their journey through a unified brand that now encompasses RelayHealth, RxCrossroads by McKesson, McKesson Prescription Automation and CoverMyMeds.

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

Good Days Patient Assistance

Good Days is a national non-profit charitable organization that lifts the burdens of chronic illness through assistance, advocacy, and awareness.

  • Provides up to $7,500 per year for prescription copays
  • U.S. resident, valid SSN required
  • Income at or below 500% FPL
  • Medicare, TRICARE, CHAMPVA, and Blue Cross/Blue Shield Federal
  • This program does not use public charge as an eligibility determination

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.

GoodRx.com

GoodRX's mission is to build better ways for people to find the right care at the best price. Our technology gives all Americans — regardless of income or insurance status — the knowledge, choice, and care they need to stay healthy.

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

Federal Ready, Set, PrEP

  • Covers cost of Truvada or Descovy
  • No income limit
  • Must be uninsured, no age restrictions
  • Resident of the U.S. or its territories; Social Security Number (SSN) not required
  • This program does not use public charge as an eligibility determination


Paying for PEP

Most health insurance plans will cover the medical costs related to getting PEP. If the cost of PEP is more than you can afford, various drug company patient assistance programs may be able to help, especially if you’re uninsured. You may need to apply to more than one, depending on the meds you’re prescribed.