How to pay for PrEP

Are you thinking about starting on PrEP but worried about how to pay for it? Read on!

Is PrEP covered by health insurance?
The good news is that most health insurance plans cover some or all of the cost of PrEP. Contact your insurance provider to learn more.

I don’t have health insurance. Can I get PrEP?
More good news! There are programs in Massachusetts that can help cover the cost of PrEP.

The Massachusetts Pre-Exposure Prophylaxis Drug Assistance Program (PrEPDAP) can help cover the cost of PrEP. The program is open to Massachusetts residents who are HIV-negative and earn less than $63,800 annually. If you’re eligible, PrEPDAP pays for prescription and office visit co-pays (or the full cost of the medicine if you don’t have prescription coverage).

If you’re taking PrEP or PEP to prevent HIV and need help with health insurance, CRI’s BRIDGE Team may be able to help. The BRIDGE Team provides assistance to people with health insurance issues.

What if I’m on my parents’ or partner’s insurance?
If you are on someone else’s health insurance and you are worried about them getting billed for services, you may be able to keep your billing private. Normally, the subscriber of the plan (e.g., parent or partner) gets an insurance form about your visits. It may list the place, date, and cost of the visits. Your insurance company may be able to send it directly to you instead.

You can ask to have your billing information kept private when you get services like:

• HIV/STD tests or treatment
• HIV PrEP or PEP
• Viral hepatitis tests or treatment
• Treatment for alcohol, tobacco, and other drug use
• Mental health care
• Gender affirmation/transition care
• Partner or domestic violence support

To ask if you can receive the insurance form directly, you must call your insurance company (use the customer service phone number on the back of your insurance card). Ask if you can receive insurance billing information directly, instead of your parent or partner. Provide any information you are asked for such as the policy number on your insurance card and the visit dates. The insurance plan will inform you if you can make this change.

Can I afford retesting while on PrEP?
In order to continue on PrEP, your healthcare provider will likely require retesting for HIV and STDs. If you’re concerned about the cost of regular testing, check out these PrEP programs in Massachusetts that may help lower or cover the cost of testing.

Gilead, the maker of Truvada^® and Descovy^®, also offers programs to help cover the cost of PrEP. Visit the Truvada^® for PrEP or Descovy^® for PrEP sites to learn more.

Okay, I can pay for PrEP. Where can I get it?
Talk to your doctor about getting PrEP. If your doctor won’t prescribe PrEP, or if you don’t have a doctor, search for services near you in Massachusetts.