Letter to Delta Air Lines on not covering a PrEP medication in employee insurance plans

*Update: Delta responded to our letter saying that it will continue to cover PrEP drugs, including Descovy. See their note below.

August 23, 2025

Dear Mr. Schmid:

Thank you for writing to express your concerns regarding coverage of PrEP medications by Delta’s health plans.

I am writing to inform you that the enrollee notice included with your letter was sent inadvertently. Delta’s health plans continue to cover all three formulations of PrEP without cost-sharing subject to the terms and conditions of the plans.

Henry H. Ting, MD, MBA
Senior Vice President and Chief Health & Wellness Officer
Delta Air Lines 

Mr. Ed Bastian
Chief Executive Officer, Delta Air Lines
1030 Delta Boulevard
Atlanta GA 30354-1989

Re: Delta Air Lines Employee Plan Coverage of HIV Pre-Exposure Prophylaxis (PrEP)

Dear Mr. Bastian:

The HIV+Hepatitis Policy Institute is a national, non-profit organization whose mission is to promote quality and affordable healthcare for people affected by HIV, hepatitis, and other serious and chronic health conditions. 

We are extremely alarmed that Delta Air Lines has decided not to cover certain HIV Pre-Exposure Prophylaxis (PrEP) medications in some or all of its employee health plans, as required by law.  Attached to this letter is a notice sent to an enrollee indicating that Descovy, a daily oral PrEP drug, will no longer be covered by Delta’s health insurance plan beginning on August 1, 2025.  This change affects all enrollees (employees and their family members). 

Under section 2713 of the Affordable Care Act, non-grandfathered private insurance plans have been required to cover PrEP medication and associated services without cost-sharing since the United States Preventive Services Task Force (USPSTF) recommended PrEP with an “A” rating in 2019 (https://bit.ly/3GRsGtw).  The USPSTF updated this recommendation in 2023 to include new PrEP options including Descovy and a new long-acting injectable (https://bit.ly/4lEL3Bd).  Non-grandfathered plans have been required to comply with this updated recommendation for all plan years beginning after August 31, 2024.

In October 2024, the Departments of Labor, Health and Human Services and Treasury issued guidance confirming that all PrEP medications and services must be covered without cost-sharing.  In addition, it makes clear that prior authorization is not allowed for the purpose of steering PrEP users to a specific drug (https://bit.ly/3Uiv2EK).

With approximately 100,000 employees in the United States, many of whom are either using PrEP or among the 2.2 million Americans who would benefit from it, Delta should not end coverage of a drug for the prevention of HIV in clear violation of federal law and implementing guidance.   With the state of Georgia facing one of the highest HIV burdens in the country, and Atlanta among the top cities for new diagnoses, it is critically important for Delta’s employees and family members and the communities they live in for Delta Air Lines’ coverage of PrEP to follow the law.  We know that Delta has prided itself as a leader in LGBTQ+ inclusivity, which makes this action all more surprising. Delta Air Lines itself benefits when its employees and their family members are able to stay healthy by protecting themselves from preventable serious medical conditions. 

We urge you to quickly investigate and resolve this matter to ensure that Delta complies with the law and enables its employees to benefit from the latest science by covering all PrEP medications now and in the future, including the newest long-acting drugs, without cost-sharing or burdensome prior authorization requirements. 

For your information, we have formally brought Delta’s lack of coverage of PrEP to the attention of the U.S. Department of Labor. 

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
Dr. Henry Ting, Chief Health and Wellness Officer
Keyra Lynn Johnson, Chief Diversity, Equity, Inclusion & Social Impact Officer