Payers are responsible for covering preexposure prophylaxis, a drug therapy that prevents HIV infection, for their members at no cost, the Department of Labor announced July 19.
PrEP received a United States Preventive Services Task Force recommendation in 2019 for those at high risk of contracting HIV. Because of that recommendation, insurers are required to cover it at no cost, the department said.
Also included in the recommendation are associated services including HIV testing, pregnancy screening, hepatitis B and C testing, sexually transmitted infection testing, and more. These services, all associated with PrEP, must also be covered in conjunction with the drug.
Insurers have coverage flexibility, however, and may cover a generic version of PrEP compared to a branded counterpart, but it must still be offered at no additional cost.