The federal government issued guidance Monday stating that almost all health insurers must cover HIV prevention drugs — such as Gilead’s Truvada and Descovy — with no cost-sharing, as well as associated lab testing and follow-up visits. Insurers were already required to quit charging out-of-pocket fees for the drugs, called HIV Preexposure Prophylaxis (PrEP), by January of this year. But now insurers have 60 days to comply with the additional requirements, including no-cost services like baseline and follow-up testing, as well as monitoring, according to the guidance.
Federal government: Insurance must now cover PrEP costs
The Biden administration is directing insurance companies to offer PrEP without copays or deductibles. PrEP, or pre-exposure prophylaxis, refers to two antiviral medications — under the brand names of Truvada, which was approved by the federal Food and Drug Administration in 2012, and Descovy, which was approved in 2019 — that are taken by HIV-negative people to prevent HIV infection.
Insurers must cover PrEP and related services to prevent HIV
The federal government reminded health insurers that they must cover pre-exposure prophylaxis (PrEP) to prevent HIV and that they must do so at no cost to clients. The federal guidance clarified that insurance plans must also cover the health services related to PrEP, such as doctor visits, blood work and tests for HIV and sexually transmitted infections (STIs).
PrEP, the HIV prevention pill, must now be totally free under almost all insurance plans
In a move that is expected to prove transformative to the national HIV-prevention effort, the federal government has announced that almost all health insurers must cover the HIV prevention pill, known as PrEP, or pre-exposure prophylaxis, with no cost sharing — including for the drug itself and, crucially, for clinic visits and lab tests.
U.S. insurance companies must now cover PrEP with no cost-sharing
In a massive move, the Biden Administration has released a new guidance that directs most health insurance companies to offer pre-exposure prophylaxis to beneficiaries at no cost.