HIV+Hep in the News

Tens of thousands of people most vulnerable to contracting HIV are forced to pay for medication to prevent the virus, despite federal requirements guaranteeing free access to treatment that is critical to ending the HIV/AIDS epidemic in the United States, according to multiple studies and interviews with medical professionals, activists and patients.

Despite the mandate, patients still face bills or prior authorizations, which means that approval must be obtained from their insurance company before starting the medication; otherwise, the medication will not be covered. Up to a third of commercially insured PrEP users paid out-of-pocket for lab testing even after the 2021 mandate. The recourse for patients facing charges when these preventive services should be free is limited. They can either try to push back on their health plan, rely on their provider to do so, or submit a complaint to agencies like their state’s Office of Attorney General or the Division of Insurance. “It is out of control,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, tells Uncloseted Media/Fierce Healthcare. “We need enforcement.”