Simply Put

[Jaegar]

Here's my situation -

 

- I've done some moderately risky things.

- Thinking PrEP is a good idea.

- Have great, gay-friendly clinic nearby (Fenway Health).

- Confident a Doctor there would prescribe Truvada for PrEP.

- Awesome, but ..

- Truvada isn't covered by my insurance, and I doubt I could afford co-pays if it were.

 

That's where I'm at. Is this Gilead thing the most viable way forward?

[rawfuckr]

- Truvada isn't covered by my insurance, and I doubt I could afford co-pays if it were.

 

That's where I'm at. Is this Gilead thing the most viable way forward?

 

How do you know Truvada isn't covered by your insurance? I haven't seen a single health plan that doesn't.

 

Then, Gilead just upped their assistance program to people making less than $58K. If you make less than $58K and your insurance doesn't cover Truvada you should be able to get it for free. Also they are increasing the copay assistance from $200 to $300

[Jaegar]

How do you know Truvada isn't covered by your insurance? I haven't seen a single health plan that doesn't.

 

Then, Gilead just upped their assistance program to people making less than $58K. If you make less than $58K and your insurance doesn't cover Truvada you should be able to get it for free. Also they are increasing the copay assistance from $200 to $300

 

I have Tricare; it may be covered by them now, but I didn't see it under the list of covered prescriptions a few months ago.

 

Come to think of it, though, I have double coverage as I'm still covered by my parent's insurance, but I don't think I want to use theirs.

[Guest kazore]

Tricare is a government insurance. Prep should be covered.

[kinkygradstudent]

In general most insurance plans will cover it if it is validly prescribed for an FDA-approved use, such as PrEP.   I would suggest you start by getting a prescription and trying to fill it, and if that doesn't go through, the pharmacist will let you know what the next step you need to take in order to get approval from your insurance company is.

[seaguy]

Check with your local AIDS health organization unless it's the AHF since they are anti PrEP.  But often they know of programs and stuff that you can apply for to get PrEP.  Some insurance companies require pre-authorization for Truvada but if you tell your doctor your high rish because say your seeing an HIV poz guy then that should get  your covered.

 

I live in WA and found this recently it is a presentation the medicaid pharmacy director  made when they were discussing covering PrEP.  http://www.hca.wa.gov/pdp/documents/truvada_for_prep.pdf  Because of  the cost and state budgets being tight I think you might see govt funded insurancew covering it but they will require preauthorization as a means of making sure that it is only being covered for those who really need it or will benefit from it because with the cost it could be looked at down the road by some person who likes to request public records and then review them and ask questions.  There are people like that and if they are homophobic this could be a target.

[backpackguy]

Agree w/Kazore. As Tricare is a health insurance program for members of the military and their families developed and paid for by the Government, Truvada (as a PrEP) should be covered. You need to look deeper into this, to include calling a knowledgeable Tricare representative.

 

If you are going to take bare loads you need to be on PrEP or its merely a matter of time before you catch the fuck flu. 

[tallbtm]

Fenway Health in Boston is VERY knowledgable about PrEP and doctors there are prescribing it. (Fenway Health was one of the early trial sites back when PrEP was still being tested several years ago There's lots of info about PrEP on their website. Truvada as PrEP is not in trials anymore; it's fully approved for use in the U.S. and Fenway Health advocates it. ALL insurance companies in the U.S. are covering it.) You should have no problem getting a prescription at Fenway Health from any of their doctors.

 

Fenway Health's own pharmacy WILL DEFINITELY process your Gilead co-pay card along with your insurance so your out-of-pocket co-pay will be exactly $0.00. (They do it for me every single month.)

 

And last, Fenway Health has VERY helpful people who will help you figure out any insurance concerns. Talk to them and they will help you.