How to afford PrEP and HIV meds if you lose health insurance

If you’re one of the more than 44 million people who have become recently unemployed thanks to the COVID-19 pandemic, you may be worried about what that might mean for your access to health care, HIV care, or PrEP.  

“We have seen a lot of people in our PrEP program or who receive our HIV services–in addition to new clients who have recently lost their health insurance–who come in wondering how to afford their medications,” said Reina Hernandez, PrEP benefits and HIV linkage manager. 

“Income from unemployment benefits might put you above the Medi-Cal threshold, meaning that you won’t be able to access full-scope Medi-Cal coverage. And then you’re left choosing whether to use your unemployment benefits to buy insurance or on other necessities like food and rent,” they said. 

The good news is that there are a variety of free programs that can help people afford HIV and PrEP treatment and care even if they don’t have insurance, said Hernandez. Gilead’s medication assistance program covers PrEP and the HIV medications made by the company. ADAP, California’s AIDS Drug Assistance Program, can help cover medications, out-of-pocket lab and medical visit costs, in addition to insurance premiums. (You can find a full list of PrEP affordability programs at PleasePrEPMe.org.)

It can be difficult to figure out which programs you qualify for, and how to apply and use benefits, which is where benefits navigators can help. 

At San Francisco AIDS Foundation, Hernandez’s team meets with people who need help signing up for and using benefits programs and health insurance (the team can process applications Covered California during open enrollment and the special enrollment period created in response to COVID-19). They also take calls and answer questions by email from people who may live outside the San Francisco Bay Area, and can also link people to providers in their local area.

“Call us, email us, leave us a voicemail, or come in to see us in person. We’ll make sure that you get onto some kind of assistance program, regardless of your immigration status,” said Hernandez. “Even if you’re just visiting the U.S. temporarily, or are living here long-term without residency, we can help.” 

If you live outside the San Francisco Bay Area, and are interested in seeing a local benefits navigator, contact any local community health centers or AIDS service organizations in your area to find out if that service is offered. You can also use the PleasePrEPMe.org search tool, filtering results by “accepts uninsured.” If you call a PrEP or health care provider, ask if they have benefits managers, case managers, or social workers who can help you find and apply for assistance programs. 

“What this epidemic has demonstrated is that we can’t rely on employer-provided health insurance,” said Hernandez. “COVID-19 has shown us the shortcomings of our current systems–health care in addition to financial, political and social. Since employment isn’t guaranteed, health insurance tied to employment just isn’t sustainable. We need to move to systems like single-payer universal health care, where regardless of your employment you have coverage.”