Most people in the United States can get PrEP at no cost through a combination of insurance mandates, federal programs, and manufacturer assistance. The path depends on whether you have insurance, what kind you have, and your income level. Even without any coverage, multiple programs exist specifically to eliminate the financial barrier.
Private Insurance Must Cover PrEP at No Cost
The U.S. Preventive Services Task Force gave PrEP an “A” grade recommendation, meaning it’s considered an essential preventive service. Under the Affordable Care Act, private insurers are required to cover A-rated preventive services with zero cost-sharing. That means no copays, no deductibles, and no coinsurance for the medication itself.
This mandate was briefly threatened by a legal challenge (Braidwood Management v. Becerra), but the Supreme Court ruled in 2025 that the Task Force members were properly appointed, preserving the legal foundation for the coverage requirement. If your private insurer is charging you for PrEP, you have grounds to appeal.
The coverage extends beyond just the pills. Insurers must also cover the clinical services that go along with PrEP: HIV testing, lab work, and office visits related to prescribing and monitoring the medication. If you’re on a private plan and being billed for any of these, contact your insurer and reference the USPSTF Grade A recommendation.
Medicare Covers PrEP and Related Services
Medicare covers PrEP without cost-sharing under Part B. That includes up to 8 HIV screenings per year using FDA-approved tests, up to 8 counseling visits every 12 months (covering risk assessment, risk reduction, and medication adherence), and a one-time hepatitis B screening. You won’t owe deductibles or copayments for these services.
The Ready, Set, PrEP Program for Uninsured People
If you don’t have insurance that covers prescription drugs, the federal Ready, Set, PrEP program provides PrEP medication at no cost. To qualify, you need to meet four criteria:
- You lack health insurance coverage for prescription drugs
- You’ve tested negative for HIV before enrolling
- You have a valid PrEP prescription
- You live in the United States, including tribal lands and territories
There’s no income limit for the medication itself. However, the costs of clinic visits and lab tests may vary depending on your income, since the program covers the drug but not necessarily every associated service. You can enroll at getyourprep.com or by calling 855-447-8410.
Manufacturer Assistance Programs
The companies that make PrEP medications run their own patient assistance programs, each with different eligibility rules.
Gilead’s Advancing Access (Truvada and Descovy)
Gilead covers the two oral PrEP medications, Truvada and Descovy. Their program is available to people with household income at or below 500% of the federal poverty level, which works out to roughly $60,300 per year for a single person (higher in Alaska and Hawaii). If you qualify, the medication is free.
ViiV Healthcare (Apretude Injections)
If you’re interested in the injectable form of PrEP, which is given every two months instead of taken daily, ViiV Healthcare offers Apretude at no cost to qualifying patients. You’re eligible if you’re uninsured or on Medicare and meet the program’s income criteria. The program doesn’t cover people enrolled in Medicaid, ADAP, or other government-funded health plans (aside from Medicare). To apply, call 1-844-588-3288.
State PrEP Assistance Programs
Several states run their own PrEP assistance programs that fill gaps the federal programs don’t cover. These typically help with the costs that surround the medication: lab tests, clinic visits, and copays. California, for example, established its PrEP Assistance Program in 2018 specifically to help HIV-negative residents access both the medication and the clinical services needed to stay on it. New York, Illinois, Washington, and other states run similar programs. Your state health department’s HIV prevention page will list what’s available locally.
How to Find a PrEP Navigator
Figuring out which programs you qualify for and actually completing the paperwork can be confusing. That’s what PrEP navigators are for. These are staff members at clinics and community health organizations whose entire job is helping people access PrEP without cost barriers. They’ll walk you through enrollment in assistance programs, help you file insurance appeals, and connect you with local resources for lab work and clinic visits.
The CDC’s National Prevention Information Network maintains a searchable database of PrEP providers at npin.cdc.gov. Clinics that offer navigation services are specifically tagged with “PrEP Navigation” in their profiles under the Support Services section. Many of these clinics also provide PrEP access assistance more broadly, helping with enrollment in financial programs even if they don’t have a dedicated navigator on staff.
Putting the Pieces Together
The reality is that getting PrEP for free often means stacking programs. The medication might be covered by one source while lab work and office visits are covered by another. A common combination for uninsured people: Ready, Set, PrEP covers the drug, a state assistance program or community health center covers the clinical costs, and a PrEP navigator coordinates everything. For insured people, it can be as simple as confirming your plan covers preventive services and finding a provider who prescribes PrEP. If your insurer pushes back with prior authorization requirements or surprise bills, a navigator can help you fight that too.
The bottom line is that cost should not be the reason anyone skips PrEP. Between federal mandates, manufacturer programs, and state-level support, the infrastructure exists to make it free for nearly everyone. The first practical step is searching the CDC’s provider database for a PrEP-prescribing clinic near you and asking about financial assistance before your first appointment.