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Medicare coverage of Truvada is less than adequate. You'll pay more than $200 a month for a prescription. Furthermore, Gilead does not provide assistance cards to Medicare patients. So until an affordable generic comes along, PrEP is out of reach for much of the over-65 cohort.
I recently renewed my Truvada and had been thinking about switching to Descovy. I work for a health system and have to use a copay coupon for the 150 copay. When I picked up my prescription it was the generic and the health system paid it completely approximately $950 vs what they previously paid. No copay for me thankfully.
I don't know how people in the USA tolerate the huge ARV prices and other medicine / medical prices there. I know you have various insurance schemes, Co-Pay, and charitable schemes, but some have to pay the whole price. Effectively your Fed and your States agree to pay part or all of the huge fees for ARVs to your Pharmas. Why? Why do you let it happen? Why do your Reps and Senators allow it? Why do you vote for Reps and Senators that allow this?
Check with your health plan's member services to see if the generic can be covered with a $0 preventive copay/coinsurance. Your doctor will likely need to send in clinical information, and your doctor will specifically need to ask for a tier exception, cost share exception, health care reform $0 preventive drug review, or something similar to those words. Not all health plans will do this, and it depends on whether the plan is governed by State law (and what specific State) or by ERISA. YMMV
I've been on Truvada for Prep for a few years now, always relying on the Gilead Co-pay card to cover the huge deductible every month until my insurance pays the full price. It usually evens out about mid-year. But once the generic was officially available, I received a letter from Gilead stating they could no longer cover the costs. California passed a law that bars co-pay assistance once a generic version is available. Nice huh? I am facing $thousands in bills to continue, so I'm quitting Prep.
Betty
just got my regular monthly notice stating on March 1 Truvada will not be covered at all .Maybe try Emtricitabine-Tenofovir Disop 200-300 MG My insurance is from a large hospitable chain in my Area. Baycare Plus Since I know this is a great Merk drug I may change insurance companies.
February 28, 2021