Private PrEP Co-pay Assistance Programs for Underinsured Patients
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Gilead Advancing Access is a co-pay assistance program available from the manufacturer of Truvada and Descovy, the two medications approved for PrEP.
WHAT IT COVERS: The co-pay card covers the patient’s out-of-pocket costs for either of the two medications up to $7,200 per year. It does not cover out-of-pocket costs for clinical visits or labs.
WHO IS ELIGIBLE: It is available to individuals who have private health plan coverage, including Marketplace plans like the ones on PrEPcost.org, and to those with employer-sponsored plans. There are no income restrictions to access this program.
Kaiser Copay Waiver
HOW IT WORKS: Follow the link below or call 1-877-505-6986 for assistance. Complete the online application, selecting Co-pay Support, then “Truvada” or 'Descovy' for the medication, and indicate that you intend to use it “to reduce the risk of getting HIV-1.” You will know immediately if you are eligible for assistance. Save or print the program’s card to use to pay for the medication at the pharmacy.
ENROLLMENT LINK: https://www.gileadadvancingaccess.com/
NOTE: Kaiser Permanente health plans require clients to apply for the Gilead Co-pay Coupon Card, then pay for the medication directly and submit a reimbursement form through the website: www.patientrebateonline.com
The Patient Advocate Foundation offers a Co-Pay Relief Program that is available for PrEP.
WHAT IT COVERS: It covers the patient’s out-of-pocket costs for the medication up to $7,500 per year. It does not cover out-of-pocket costs for clinical visits or labs.
WHO IS ELIGIBLE: It is available to individuals who have health insurance that covers Truvada® and whose income falls below 400% of the Federal Poverty Guideline, adjusted by the Cost of Living Index and the number in the household.
HOW IT WORKS: Follow the link below, or call 1-866-512-3861, Option 1 for assistance. Register for the program and then complete the online application. You will know if you are eligible for assistance within 10 minutes of submitting the application. An income verification may also be required.
In addition to the programs outlined above, other financial assistance may be available based on health insurance type and income. Good Days offers co-pay assistance for PrEP for individuals with Medicare or Military insurance coverage. Co-pay assistance from the PAN Foundation may also be available for PrEP patients with Medicare coverage, although this program is currently closed.
A number of states have established their own PrEP Assistance Programs. Most cover out-of-pocket expenses for the medication as well as clinical visits and labs, see the table below.
In most of these states, both the PrEP patient and the provider must complete an application to participate in the program. Please follow the link to your state’s program for more information.
*In these states, PrEP medication assistance is only available through local health department clinics or select contracted providers.
Some PrEP Assistance Programs may consider providing medication assistance to PrEP candidates on a case by case basis when the individual is categorically ineligible for health insurance coverage or cannot use their health insurance plan for PrEP.
California: For questions about the PrEP-related medical out-of-pocket benefit, please call (877) 495-0990. For more information about benefits and enrollment, please visit: www.cdph.ca.gov/Programs/CID/DOA/Pages/OA_adap_benefits_prepAP.aspx.
Colorado: For more information about the program or to enroll online, visit www.coenroll.com. Visit www.proudtobeprepped.com to learn about the different options to pay for PrEP in Colorado.
District of Columbia: For more information visit: https://dchealth.dc.gov/node/1333931 or call the program at: (202) 671-4815.
Florida: Call 1-850-245-4422 for more information about Florida’s PrEP Drug Assistance program and participating health department clinics.
Illinois: For more information about the program or to enroll online, visit www.prep4illinois.com, or call the program’s hotline: 1-800-825-3518.
Massachusetts: Visit the program’s website to find out more: https://crine.org/hdap/prep-drug-assistance-program/ or call CRI’s PrEP Coordinator at 617-502-1737 (or toll free at 800-228-2714 x3737).
New York: Call 1-800-542-2437 to enroll and for more information, visit: https://www.health.ny.gov/diseases/aids/general/resources/adap/index.htm.
Ohio: Scheduled to launch at the beginning of 2019. Please visit www.ohiv.org or call the state’s HIV/STD hotline 1-800-332-2437 for more information.
Virginia: Call 1-800-533-4148 for more information about Virginia’s PrEP Drug Assistance Program and participating providers.
Washington State: Please visit www.doh.wa.gov/prepdap or call 1-877-376-9316 for more information.
Kaiser Prep Copay Program
Private PrEP Medication Assistance Program for Uninsured Patients
For uninsured individuals, the Gilead Advancing Access Medication Assistance Program can help cover the cost of Truvada or Descovy for PrEP.
WHAT IT COVERS: The program provides financial assistance to pay for Truvada or Descovy, the two medications for PrEP. It does not cover the cost of clinical visits or labs.
WHO IS ELIGIBLE: The program is available to uninsured individuals, regardless of immigration status. The household income limit for the program is 500% FPL ($60,300 per year in all states except Hawaii and Alaska). Applicants will be asked to submit further documentation as proof of income.
HOW IT WORKS: Follow the link below or call 1-800-226-2056 for assistance. Complete the online application, selecting “Uninsured Support,” then “Patient Assistance Program (PAP) Eligibility Screening.” Select “Truvada” or 'Descovy' for the medication, indicate that you intend to use it for PrEP, and enter your personal information. Your PrEP provider will also need to complete a portion of the application.
Kaiser Prep Copay Online
ENROLLMENT LINK: https://www.gileadadvancingaccess.com