On World AIDS Day, Pennsylvania Insurance Department (PID) Policy Director Katie Merritt joined representatives from the Pennsylvania Commission on LGBTQ Affairs and Hamilton Health Center to highlight the importance of HIV pre-exposure prophylaxis, or PrEP, medication for HIV prevention, and to detail insurance coverage of the drugs under the Affordable Care Act.
“We want to remind consumers that the federal government requires most insurers to cover HIV PrEP medication at zero cost to the consumer, if the consumer is at high risk of HIV acquisition,” said Merritt. “Nobody should ever forgo medically necessary preventive medication or services because of cost, and the department is committed to ensuring that all health insurance plans under its jurisdiction are following the requirements to cover PrEP and related services without cost sharing.”
“Zero-cost” means that the consumer will not be charged an out of pocket copayment, deductible or coinsurance for these drugs. Tests, doctor visits, and other services directly related to obtaining PrEP and included in the PrEP billing, should also be covered with no out of pocket cost to the consumer.
