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Insurance companies will soon have to cover HIV prevention pill at no cost to patients

PrEP considered effective preventive care
Posted: 12:00 PM, Jun 12, 2019
Updated: 2019-06-12 20:40:41-04
Daily Antiretroviral Pill Found To Protect Healthy From AIDS Transmission

DENVER — In a couple years, people at risk of contracting HIV will be able to receive pre-exposure prophylaxis, also known as PrEP, without paying a copay or other out-of-pocket expenses.

The U.S. Preventive Services Task Force, an independent panel of experts that issues recommendations about evidence-based preventive health care, issued final recommendations this week that call for screening everyone ages 15 to 65 for HIV as well as providing PrEP to patients at high risk of contracting the virus.

Both recommendations got an “A” grade, meaning most insurance providers will be required to offer PrEP as a preventive service without copay, coinsurance or other costs to the patient, as set forth by the Affordable Care Act. Screening for HIV — the virus that causes AIDS — is already covered under the ACA.

PrEP, which is sold as a once-daily pill under the brand name Truvada, has been shown to be highly effective in preventing the transmission of HIV when patients take it regularly. A generic version of PrEP is expected in 2020.

PrEP is recommended for people who have sex partners with HIV, those who don’t use condoms regularly and people who inject drugs, as those behaviors put a person at higher risk of contracting HIV.

According to government health data, about 1.1 million people in the United States are living with HIV and there are approximately 40,000 new cases every year. About 1 in 7 people with HIV don’t know they have the virus and could transmit it to others without knowing.

The Colorado Division of Insurance said it will begin working with insurance providers, consumer groups and other stakeholders this year and into 2020 to implement the new guidelines for coverage beginning in 2021.

Read more about the new recommendations here.