The U.S. Preventive Services Task Force (USPSTF) recommends clinicians offer PrEP to individuals who may have a higher chance of getting HIV.
In 2019, the U.S. Preventive Services Task Force (USPSTF) issued a Grade “A” recommendation for PrEP (pre-exposure prophylaxis) medications, strongly recommending clinicians provide PrEP services to eligible patients.
When services and items like prescription medicines receive a Grade A or Grade B recommendation from USPSTF, the Affordable Care Act requires coverage by certain insurance plans‡ with no cost sharing by individuals for the medicine.
For PrEP medications, under the Affordable Care Act, plans should accommodate individuals for whom a particular PrEP medication (generic or brand name) would be medically appropriate, as determined by the individual’s healthcare provider. In addition, PrEP-related lab tests and other services, such as adherence counseling, may also be covered without cost sharing by certain insurance plans.
‡All non-grandfathered commercial payers and Medicaid expansion plans.
§Gilead is not affiliated with PleasePrEPMe.