I think PrEP is right for me.
What is PrEP?• Pre-ExposureProphylaxis(PrEP)iswhereHIV-negativepeopletakedailymedicationtoreducetheirriskofgettinginfectedwithHIV.
• TruvadaiscurrentlytheonlyFDA-approveddrugforPrEP.
• RiskforHIVinfectionreducedbymorethan90%amongthosewhotakeTruvadaforPrEPconsistentlyeveryday.
• InSanFrancisco,thosewhoareathigherriskofHIVexposureincludegayandbisexualmen,peoplewhoinjectdrugs,andtransgenderwomen.
How and where can I get PrEP?• Youwillneedtovisitahealthcenterthatprovidesprimarycareservices.
• TruvadaforPrEPisavailablebyprescriptionfromdoctors,nursepractitioners,and/orphysicianassistants.
• YouwillneedtotalkwithyourmedicalprovideraboutyoursexualhealthwhenyouaskforTruvadaforPrEP.
• Yourprovidermayneedtogetpre-authorizationtogiveyouaprescription;itmayincludelabtestsand/orfillingoutpaperwork.
• Mostprivatehealthinsuranceplans,aswellasMedicaid,coverthecostofTruvadaforPrEP.
• Whenstartingitwilltakeupto7daysoftakingdailyTruvadaforPrEPtoreachhighlevelofHIVprotection.
What other costs should I consider?WhenyouarecalculatingyourhealthcostsforPrEP,rememberthatitinvolvesmorethanjustthedrugitself.Youwillneedtoaccountforfrequentvisitsandlabtests.
• Branddrugcopay/coinsurance(permonth)
• Primarycarevisitcopay(atleast3–4timesperyear)
• Labtestingcopay,supplies,andservices(pervisit)
How much does the drug cost?TruvadaisabrandnamedrugandnogenericversioniscurrentlyavailableintheU.S.
• Without insurance:Asmuchas$1,800amonth.
• With Medi-Cal and/or Medicare:Coveragevariesfromstatetostate;talkwithabenefitscounselor.
• With insurance:Costsvarydependingonyourinsurer’sstandardcopay/coinsuranceassociatedwithbrand-namedrugs.Contactyourinsurancecompanydirectlyforpricing.
SAN FRANCISCO
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PrintedFebruary2014
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IMPORTANT: If you are an uninsured California resident in need of affordable health insurance, the deadline to sign up for 2014 coverage is March 31, 2014. For more info, call (800) 300-1506 or visit www.coveredca.com.
•With Covered California:Between$15–$700permonthdependingonwhichlevelyouchoosewithcopaysanddeductibles.
• Bronze Plan:$50/brandcopayafter$5,000deductibleforbothmedicalanddrugswhereyoupay40%ofhealthexpenses.WARNING: Unaffordable; do not enroll in this tier if you plan on starting PrEP.
• Silver Plan:$50/brandcopayafter$250branddrugdeductiblewhereyoupay30%ofhealthexpenses.
• Gold Plan:$50/brandcopay,nodeductible.
• Platinum Plan:$15/brandcopay,nodeductible.
If you are an uninsured San Francisco resident who does not qualify for Medi-Cal or Covered California and your income is less than $54,000 (500% federal poverty level), then consider Healthy San Francisco to increase your access to health services. It is not health insurance. For more info, call (415) 615-4555 or visit www.healthysanfrancisco.org.
• With Healthy San Francisco (HSF):Between$0–$25throughSanFranciscoDepartmentofPublicHealthdependingonincome;pricesvarythroughHSFMedicalHomesbyclinic.YoumaybeaskedtoenrollinGileadSciences’MedicationAssistanceProgram(seebelow)toreduceyourout-of-pocketcosts.
Payment Assistance:
•Gilead’s Medication Assistance Program (MAP) for PrEP:Ifyoudonothavehealthinsurance,thenapplyforthisprogramtoseeifyouarefinanciallyeligibletogetTruvadaforPrEPforfree.Youmustnothavehealthinsuranceandincomeverificationisrequired.Yourproviderneedstosubmitanappli-cationform.Ifapproved,yourmedicationwillbedispensedtoyourproviderdirectly.Formoreinfo,call1-855-330-5479orvisitwww.truvada.com.
• Gilead’s Co-Payment Assistance Program (CAP):Ifyouhavehealthinsurance,saveupto$200permonthonyourTruvadacopayments.There is no financial income restriction for eligibility.Yourproviderorpharmacycansubmittheapplicationform.Onceapproved,youwillbegivenacardandmedicationwillbedispensedtoyourpreferredpharmacy.Formoreinfo,all1-877-505-6986orvisit www.truvada.com.
• Gilead’sMAPandCAPbothusesameapplicationform:https://start.truvada.com/Content/pdf/Medication_Assistance_Program.pdf
•IfyouareenrolledinMedicaid,orMedicareorhavecoverageforprescriptiondrugsunderanyotherpublicprogramorotherthirdpartypayer,thenyouarenoteligibleforGilead’sMAPandCAP.
If you are running into problems getting a prescription for PrEP, please contact us at [email protected] to help troubleshoot.
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