The 2023 United States Preventive Services Task Force (USPSTF) recommendation for PrEP specifically cites the three medications currently approved by the FDA for use as PrEP. Therefore, it is the position of The Departments, as outlined in FAQ 68, that plans and issuers must cover, without cost sharing, the current three FDA-approved PrEP formulations. Furthermore, plans are not permitted to use medical management techniques to direct individuals who are prescribed PrEP to utilize one formulation over another.
Currently, generic Truvada is covered under the ACA program with no cost share when used for PrEP. Based on recent USPSTF recommendation that all three current FDA-approved PrEP formulations be covered without cost sharing, we will be adding the following to ACA coverage:
Apretude (when used for PrEP only)
Descovy (when used for PrEP only)