Healthcare can be expensive. PrEP, on its own, costs a lot. That’s no joke — without coverage, it can cost almost $2,000 per month! Nobody’s got that kind of money lying around.

Luckily, there are a bunch of ways to get covered. Even if you don’t have insurance. If you take advantage of the programs out there, you can get PrEP for very little money or even for free.

Free? Like, no money?

Free — as in free to you at the pharmacy. There are a lot of great programs out there that help you pay for the PrEP medication you need – like Truvada or Descovy. 

Health Insurance

If you’ve got private health insurance through work or the Marketplace, it’s a great place to start. Health insurance helps you pay for stuff like doctors appointments, hospital visits, lab work, and prescription drugs. Most private insurance covers PrEP. But, they come with a catch: co-pays, co-insurance, and deductibles. These are monies you have to pay on top of your insurance premium. They can really add up. But, there’s help from co-pay cards.

I think I’m on my parent’s insurance

If you’re a dependent on your parent’s insurance, then you have private insurance. Generally speaking, you’ll have to use this insurance to get your PrEP covered. That also means that your parents could find out about you taking PrEP.

Medicaid and Medicare

Medicaid is a public healthcare program. How you qualify for Medicaid changes from state-to-state. In Ohio, you may be eligible if you are: 

• an individual with a low income 
• are a person who’s pregnant, a child, or an infant
• an older adult or a person living with a disability

Things like family size, condition, and age change the income limits. Generally, if you make 133% or less than the Federal Poverty Limit, you’ll probably qualify. For 2020, in Ohio, that means earning less than $1,415 per month.

For people who are over 65 or live with a disability, Medicare works with Medicaid to cover you. Medicare isn’t one thing, it’s actually a bunch of programs that work together. Prescriptions are generally covered under Part D. On top of Medicare, you may be eligible for PAPI (Patience Assistance Program Intervention) through Ohio’s Department of Health. PAPI can help you cover your cost of PrEP, including your Part D coverage, doctor visits, and lab work. There’s also Good Days, which provides up to $7,500 per year in assistance to lower-income, insured individuals.

Other Government Programs

Medicare and Medicaid aren’t the only government health programs. The Veterans Administration (VA), the Indian Health Service, and others can also help you cover the cost of PrEP.

Patient Assistance Programs (PAPs)

If you don’t have health insurance and don’t qualify for Medicaid, there’s still help. PAPs are programs that drug companies have to provide medicine to people who need them for free or at a heavily reduced cost.

Co-pay Cards

Drug companies offer people with private health insurance discounts through co-pay cards. These are amazing programs. They can pay for up to $600 per month towards your prescription co-pay or deductible. The best part is that there are no income guidelines.

 Okay, so how do I do this?

Luckily, you don’t have to do this alone. In Cleveland, we have two amazing people that help you get on and stay on PrEP. They’re called PrEP Navigators.