Most health insurance plans are required to cover HIV pre-exposure prophylaxis (PrEP) with no cost sharing and in fact do so. However, some plans have requirements for pre-authorization, which may limit access.
Health insurance plans more likely to have pre-authorization requirements are located in the South, the region of the U.S. where uptake of PrEP is more limited and where there are more HIV cases as compared to other areas.
The study in JAMA Network, Geographic Variation in Qualified Health Plan Coverage and Prior Authorization Requirements for HIV Preexposure Prophylaxis (McManus, Fuller, Killelea, et. al., 11/10/23), looked at Qualified Health Plan (health insurance plans that meet Affordable Care Act requirements) access to two FDA-approved formulations of oral PrEP. See also observations on this study in Commercial Determinants of Access to HIV Preexposure Prophylaxis.
Read PrEP Policies and Programs Help End the HIV Epidemic for guidelines, policies, paying for PrEP, and training tools.