Getting help with paying for PrEP

Whether or not you have health insurance and if you can’t cover all the costs related to Truvada for PrEP, there are ways to get help with paying for the prescription and medical copays. Depending upon what your out-of-pockets costs are (copays, deductibles, co-insurance, etc.), the assistance programs listed below may or may not be able to cover all those costs. There are eligibility requirements for each program.

FOR HELP WITH PAYING FOR THE PrEP MEDICATION:

Gilead’s Advancing Access Patient Support Program

  • Assists people without prescription benefits (uninsured individuals, or insured individuals whose plans will not pay for Truvada, or Medicare patients without Part D)
  • Doesn’t assist Medicaid patients, but will temporarily assist Medicaid-eligible patients while they wait for their coverage to start
  • Doesn’t assist people with other federal/state prescription drug programs, such as the VA or Tricare
  • Annual income at or below 500% FPL ($60,300)
  • U.S. resident, including undocumented residents
  • Social security number not required
  • Enroll by calling: 800-226-2056 (suggested for easier processing)
  • Enroll online: tinyurl.com/GileadEnrollment

FOR HELP WITH PAYING FOR OUT-OF-POCKET COSTS:

Gilead’s Advancing Access Copay Coupon Program

  • Assists people with commercial insurance and Medicare patients without Part D
  • Does not assist people with government sources of insurance (Medicaid, Medicare with Part D, the VA or Tricare, among others)
  • Kaiser patients cannot use the copay card but are still eligible for the Gilead program and should seek reimbursement from tinyurl.com/PrEPrebate
  • No annual income limit, no lifetime limit
  • Provides up to $3,600 annually
  • Enroll by calling: 800-226-2056 (suggested for easier processing)
  • Enroll online: tinyurl.com/gileadcopaycard

PAN (Patient Access Network)

  • Assists people with Medicare only
  • Must be a U.S. resident
  • May provide up to $7,500 annually, which is usually broken up into smaller grants
  • Annual income at or below 500% FPL ($60,300)
  • Enroll by calling: 866-316-7263 (suggested for easier processing)
  • Enroll online: panapply.org
  • Sometimes is closed to enrollment due to funding shortfalls

PAF (Patient Advocate Foundation)

  • Must be a U.S. resident
  • Must have a social security number
  • Must have health insurance (includes Medicare)
  • May assist with up to $7,500 annually
  • Annual income at or below 400% FPL ($48,240), with cost of living adjustments for some cities
  • Enroll by calling: 800-532-5274 (suggested for easier processing)
  • Enroll online: tinurl.com/PAFhelp
  • May be closed to enrollment due to funding shortfalls

State PrEP Assistance Programs

Five states have assistance programs that can help cover the costs of the medication and/or the out-of-pocket costs. Check these links for those program details and eligibility.

FSAs and HSAs

Flexible Spending Accounts and Health Savings Accounts are programs that employees (and sometimes their employers) can contribute pre-tax dollars to, in order to reimburse the employee for incurred medical costs. If you have one already set up, consider using funds to cover your PrEP costs. If you don’t have one set up, then ask your employer if it offers them, when they would start, and how much can be contributed to them.