Follow-up letter to Delta on employee plan coverage of PrEP
Senior Vice President
Chief Health and Wellness Officer
Delta Air Lines
1030 Delta Boulevard
Atlanta GA 30354-1989
Dear Dr. Ting:
In July, we wrote to you to express our concern that Delta Air Lines was not covering certain HIV Pre-Exposure Prophylaxis (PrEP) medications in some or all of its employee health plans, as required by law.[1] We urged you to cover all PrEP medications and services without cost-sharing, and not to employ prior authorization for the purpose of steering employees to one PrEP drug or another, as is required of all non-grandfathered commercial insurance plans in the United States.
On August 23, 2025, you replied, assuring us that the enrollee notice we had brought to your attention had been “sent inadvertently,” and that Delta would “cover all three formulations of PrEP without cost-sharing subject to the terms and conditions of the plans.”
Unfortunately, we now have learned that Delta Air Lines intends to impose prior authorization requirements to steer employees and their family members who use PrEP to the generic formulation of PrEP effective October 1, 2025. A notice to an enrollee to this effect is attached below.
The October 2024 federal guidance on PrEP coverage[2]–which was written prior to FDA approval of Yeztugo – was unambiguous that “plans and issuers must cover, without cost sharing, the three FDA-approved PrEP formulations (two oral and one injectable) and are not permitted to use medical management techniques to direct individuals prescribed PrEP to utilize one formulation over another.”
We urge you to immediately comply with the law and cover all forms of PrEP without cost-sharing and prior authorization. We look forward to your response. If you have any questions, comments, or would like to discuss these issues further, please contact Carl Schmid, Executive Director, HIV+Hepatitis Policy Institute at cschmid@hivhep.org or (202) 462-3042, or Kevin Herwig, Health Policy Manager, HIV+Hepatitis Policy Institute at kherwig@hivhep.org or (617) 666-6634.
Sincerely,
Carl Schmid II
Executive Director
cc: Allison Ausband, Executive Vice President and Chief People Officer
Keyra Lynn Johnson, Chief Diversity, Equity, Inclusion & Social Impact Officer
[1] https://hivhep.org/wp-content/uploads/2025/07/Delta-letter-on-PrEP-coverage-7.21.pdf
[2] https://www.cms.gov/files/document/faqs-implementation-part-68.pdf