People who are HIV-negative and vulnerable to HIV infection can take a daily medication called Truvada to help prevent HIV. It’s recommended by the U.S. Centers for Disease Control and Prevention and the Chicago and Illinois Departments of Public Health.
If you need health insurance, you can shop for and choose a plan on the health insurance marketplace (must be before Friday, Dec. 15). If you take PrEP, or are considering taking PrEP, we want to share some great resources to help you find the best health insurance plan for you and get help paying for PrEP.
Start here: Go to PrEPcost.org to find plans offered in your area, see if you can get help paying for the plan (known as a “subsidy”), and learn how much Truvada might cost. Developed by our partner the National Alliance of State and Territorial AIDS Directors, PrEPcost.org is a new tool to make it easy to find the right plan for you. It will also tell you if a plan has any kind of restriction that might make it harder to get PrEP, such as a requirement for a “prior authorization (your provider has to get approval from your insurance company before they can prescribe PrEP).” Prior authorizations require more time and paperwork, so it’s good to try and avoid them if possible.
Step 2: Choosing a plan can definitely be complicated. If you need help, please make an appointment with a trained assister. Tip: Schedule your appointment ASAP — don’t wait until the last minute! This open enrollment season is really busy! Remember it ends Dec. 15th.
Step 3: Enroll! Once you’ve found the plan that’s right for you, visit Healthcare.gov or the Illinois Health Insurance Marketplace (or call 866-311-1119) to enroll in a plan. The deadline is Friday, Dec. 15. You can link directly to these sites via PrEPcost.org as well.
Check out (and sign up for) these two programs that can help you pay for Truvada.
1)PrEP4Illinois: Start by enrolling in the PrEP4Illinois program (visit www.PrEP4Illinois.com or call 800-825-3518). It’s run by the Illinois Department of Public Health (IDPH). It works with the Gilead co-pay assistance program (see below), and you may be able to get Truvada with no out-of-pocket costs (for free!). PrEP4Illinois will help you access PrEP if you are insured or uninsured through a simple application process that connects you to a variety of resources. The program will help cover people who are under 18, or who are insured but might not want to use their insurance (if they’re worried about using parental insurance or are in situations where there may be intimate partner violence, for example). You must be an Illinois resident to use this program.
2)Gilead Co-Pay Assistance Program: Gilead (the manufacturer of Truvada) has a copay assistance card that will help reduce your out-of-pocket costs for Truvada. If you have insurance, you can apply for a card at https://www.gileadadvancingaccess.com/. There are no income limits. The card will pay up to $3,600 per year toward the cost of your prescription and can help you meet any deductible required by your plan. Note that not all insurance plans will allow you to use a copay card, or may have special conditions. For example, BlueCross BlueShield plans allow co-pay cards, but they do not count towards meeting your deductible. Check with the insurance plan before enrolling. Tip: PrEP4Illinois will help you enroll in the Gilead Co-Pay Assistance Program, so start there first.
More information on Gilead’s patient assistance programs:
Finally, to learn more about PrEP and where to get it, call the Chicago PrEP Line at 872-215-1905 or visit www.PrEP4Love.com. The operators at the Chicago PrEP Line are also able to help you with insurance questions in addition to answering your PrEP questions and giving referrals to friendly PrEP providers.