Has anyone used "MISTR" to get PreP?

[408curious]

I have insurance but I'm a mess about paperwork.  I understand there's a huge deductible, but Gilead has a reimbursement program....  I'm too dysfunctional to keep all this straight.

Mistr says there's no paperwork for you.

Has anyone used their service?

[BootmanLA]

I have not. However, you might inquire with your pharmacy as to whether they'll assist you in filling out the paperwork for Gilead; they may already be used to doing that.

In my case, since I'm on ART instead of PrEP, the pharmacy associated with my HIV specialist's office takes care of the Gilead copay paperwork for me at the beginning of each year. 

[astrokc]

I have used MISTR for about six months. They have taken care of all the paperwork, as well as billing my insurance.  I have not had to pay for anything and no paperwork for me equals one happy camper here. 

[1stimebare]

Anyone else have trouble getting on prep?  I mentioned it to my doctor on 2nd appointment with him.  He said I would have to be referred to an infectious disease specialist but he has not done so yet.  Another unrelated issue came up so waiting made sense but that seems to be dealt with now and I need to approach this again.  One problem is I rarely see the doctor, most appointments it's just a lab tech or nurse.  Anyone else have a doctor not want them on Prep?  He gave me a safe sex talk but did offer referral which I said I wanted but since then nothing.

[Guest NSAFUCKBUD]

I HIGHLY recommend Mistr.  They handle everything.  The process is seamless and most of it is done online.  They send you a test kit via email at no charge.  I have insurance and they handle everything.  No copayment at all.

[fskn]

On 1/22/2021 at 7:38 PM, 408curious said:

I understand there's a huge deductible, but Gilead has a reimbursement program.

Health insurance regulations and the drug marketplace have changed, likely making both points moot.

First, HIV PrEP for at-risk individuals is now a preventive service. As of January 1, 2020, the vast majority of health plans must cover PrEP-related visits, tests and medication with no cost sharing (no deductible, no flat-dollar copayment, no percentage coinsurance).

It appears that you are in California. Our state's Department of Managed Health Care issued specific guidance to health plans on this point. Although it's likely that insurers are taking of advantage of individual patients' lack of knowledge, and that doctors, test providers and pharmacies are making coding errors, you won't have to remind these parties more than one time. The CA DMHC is very strict. July 8, 2020 reminder letter to California health plans:  [think before following links] https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL%2020-026%20-%20Preventive%20Coverage%20for%20HIV%20Preexposure%20Prophylaxis%20(7_8_20)_1.pdf?ver=2021-05-07-105930-913

Second, now that generic versions of Truvada are available, it's unlikely that your health plan covers brand-name Truvada.

If you have a grandfathered health plan (about the only kind of plan that is not subject to the preventive care rules) and your doctor selects Descovy (a newer, still-patented alternative to Truvada, with one of the two drug components reformulated) you can still use Gilead's assistance programs. For patients who can use ordinary commercial pharmacies, this is as simple as calling a toll-free number one time, receiving a numbered card in the mail, and showing the card each time at the pharmacy.

Teva introduced the first generic version of Truvada in the US, but it is almost-full-price. Their assistance program was interrupted at the end of March, and then renewed through the end of April, when it expired again. Whether it will continue is uncertain.

After Teva's exclusive licensing deal with Gilead ended, Aurobindo introduced what we've come to expect of generics, a truly low-priced product (just over one dollar per daily tablet). Aurobindo does not have a patient assistance program.

But once again, the vast majority of insurance plans must now offer PrEP completely free, so paperwork, drug price considerations, and drug company patient assistance programs are thing of the past.

Edited May 24, 2021 by fskn
Hyperlink

[blackrobe]

California also has an assistance program for the uninsured that you can look into, and also passed a bill in Oct 2019 allowing prescription-free PrEP (and PEP) for HIV prevention. They really are doing some great things in California regarding HIV prevention.

[Guest Goodbye]

Wow it's very interesting reading about how knowledgeable you guys are... It's not all sex... It's sex-Ed as well love it. 

[haireebear]

18 hours ago, 1stimebare said:

Anyone else have trouble getting on prep?  I mentioned it to my doctor on 2nd appointment with him.  He said I would have to be referred to an infectious disease specialist but he has not done so yet.  Another unrelated issue came up so waiting made sense but that seems to be dealt with now and I need to approach this again.  One problem is I rarely see the doctor, most appointments it's just a lab tech or nurse.  Anyone else have a doctor not want them on Prep?  He gave me a safe sex talk but did offer referral which I said I wanted but since then nothing.

When dealing with medical professionals in most every area, you need to be your own advocate.   So, next time tell him in no uncertain terms to make the referral immediately for you.     Don't even ask it in a question.   Tell him.   

[bihairy]

18 hours ago, 1stimebare said:

Anyone else have trouble getting on prep?  I mentioned it to my doctor on 2nd appointment with him.  He said I would have to be referred to an infectious disease specialist but he has not done so yet.  Another unrelated issue came up so waiting made sense but that seems to be dealt with now and I need to approach this again.  One problem is I rarely see the doctor, most appointments it's just a lab tech or nurse.  Anyone else have a doctor not want them on Prep?  He gave me a safe sex talk but did offer referral which I said I wanted but since then nothing.

Check your insurance and see who is in your plan for infectious diseases. The ID doctor is the one to Rx if your PC is not comfortable with it.  It sounds like your doc is not comfortable with the idea of PrEP.  If you want to get on it, then speak to an ID doc and insist this is what you want!  It's your health you should be in control!

[bearsubmission]

Appreciate your guys input on this, and decided to get on PrEP for the first time via Mistr. signup was super easy, and awaiting my video meeting tomorrow morning, testing kit is on the way. 

[nekofox]

On 5/24/2021 at 3:30 PM, Goodbye said:

Wow it's very interesting reading about how knowledgeable you guys are... It's not all sex... It's sex-Ed as well love it. 

That's the thing about this site, we have our fantasies, be we do have an overall good discussion to make sure that everyone can know about actual updates for those that wish to play with Poz, Neg, Undetected, all about having that informed decision.

[Littlebill77]

(Removed from this thread.)

Edited May 31, 2021 by Littlebill77
Removed as not relevant for this thread

[1stimebare]

Well I saw the doctor again and he said he wants to refer me to one specialist which I took as an opportunity to bring up the referral that never happened and told him he has to make that happen finally.   Quickly.  If I get the one he wants me to see I may just tell him not till I see the one I want first.  Maybe this time.  At least this time no safe sex lecture.