Medication Assistance Program and Co-Pay Programs for PrEP

There are two types of programs that help people access their prescription drugs for pre-exposure prophylaxis (PrEP). PrEP is when an HIV-negative person takes antiretroviral drugs daily to prevent becoming infected with HIV. One of the programs, the medication assistance program (MAP), provides free drug to those without health insurance or prescription drug coverage. The other, a drug co-pay program, provides assistance with out-of-pocket costs (including co-pays, co-insurance and deductibles) for people who have insurance. The co-pay assistance may be obtained from the drug manufacturer, a non-profit co-pay foundation, or both.

MAPs and Copays for PrEP may have limits on the amount of money a person may earn each year to qualify for the program. This income limit is not a fixed amount. Instead it is based on the federal poverty level (FPL) for a given household. People with more people in the household may have higher household incomes than people with fewer people in the household. For instance, people with a single person in their household may earn up to approximately $58,000 per year if the income limit is 500% of the FPL.

MAP for Truvada

  • Income below 500% of the FPL and no other sources for health insurance or prescription coverage (reevaluated on a regular basis)
  • Have a prescription for Truvada
  • U.S. residency proof is required, but not immigration legal status
  • Income verified
  • Drugs shipped to provider’s office or a person’s home —may take two weeks
  • Contact: 1-855-330-5479

Co-Pay Programs

Gilead Co-pay Program for Truvada

  • Assistance is limited to $3,600 per year and may apply to co-payments, co-insurance and deductibles
  • People must have private insurance
  • This program does not cover individuals with Medicaid or Medicare
  • No income requirement
  • Issues a co-pay card for use at pharmacies
  • Works with most pharmacies, but reimburses when pharmacies don’t accept the card. Some mail-order pharmacies also don’t accept co-pay cards
  • www.gileadcopay.com or 1-877-505-6986

Patient Access Network (PAN) Foundation
*NOTE – NOT ACCEPTING NEW MEMBERS

  • $7,5000 per year
  • Does cover deductibles and co-insurance and is designed for those who’s out-of-pocket costs are not fully covered by the Gilead program
  • Income below 500% of FPL
  • People must have private insurance
  • This program does not cover individuals with Medicaid, but it does cover those with Medicare
  • Most pharmacies should be able to bill PAN directly
  • www.panfoundation.org/fundingapplication/welcome.php or 1-866-316-PANF

Patient Advocacy Foundation – Co-Pay Relief

  • $7,5000 per year
  • Does cover deductibles and co-insurance and is designed for those who’s out-of-pocket costs are not fully covered by the Gilead program
  • Income below 400% of FPL – household size and Cost of Living Index (COLI) are considered. (e.g. those with more household members or who live in very expensive cities may have higher incomes.)
  • People must have private insurance
  • This program does not cover individuals with Medicaid, but it does cover those with Medicare
  • Most pharmacies should be able to bill PAN directly
  • https://www.copays.org/diseases/hiv-aids-and-prevention or 1-866-512-3861