I Have Health Insurance

I have health insurance

PrEP is covered by most major insurers, but there are two parts to this coverage: the actual medication and required blood work. Check your insurance plan’s Summary of Benefits and Coverage.

Most insurers also have a list of covered prescriptions on their website. If you are unsure how to access this information, call the number on your insurance card and a representative will assist you.

 

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Patient Having Consultation With Female Doctor In Office

What if my insurance refuses to pay for PrEP?

  • First, check to see if your insurance lists the medication for PrEP as a drug that is covered.
  • Second, make sure that the doctor’s office filled out paperwork correctly. You can ask them to resubmit your request.
  • If you’re denied again, you have the right to appeal that decision. Get help from your provider for this process.
  • If none of this works, contact Gilead to learn more about their payment assistance programs.

What if I’m covered by someone else’s health insurance?

  • If you’re covered by someone else’s health insurance, be aware that the policy holder may be informed that you are taking an anti-HIV medication.
  • If this is a concern, first see if you can access alternate health insurance.
  • If you can’t access alternate health insurance, PrEP navigators can help you explore other options. For Connecticut residents, email PrEPNav@APNH.org or call 1.475.441.7031.

PrEP Truvada Covered by Someone Elses Insurance

My insurance covers PrEP, but I still can’t afford the co-pay

  • Gilead offers financial assistance for anyone who can’t afford their co-pay. Visit their website here for more information.

I have Medicaid, am I covered?

    • If you are in Connecticut and covered by Medicaid (Husky) then you should be covered for PrEP. Visit here for more information.
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