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BIG NEWS: PrEP will no longer be subject to insurance copays in the U.S.


BootmanLA

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The Biden administration today announced a change in regulations under the Affordable Care Act: PrEP must be provided under most insurance plans in the US with NO copays.

Under the ACA, insurance companies must provide services and drugs classified as "preventative" that have been recommended by the U.S. Preventative Services Task Force at no cost to their policy holders. PrEP technically became so classified in January of this year, but today, the government announced that companies have 60 days to begin including this coverage as required by law.

As always, there are a few exceptions. There are some pre-ACA plans "grandfathered" in under the law, which do not have to comply with the changes required under the ACA as long as they do not make certain changes to their plans (any such change immediately subjects them to the ACA). And of course, anyone who does not have insurance coverage (whether employer/group-sponsored, individual, Medicare, Medicaid, or whatever) doesn't get this benefit.

Important to note: This means that the doctor's appointments, tests, and so forth as part of the PrEP process will be covered as well, with no cost-sharing.

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