June 4, 2020
Premera is adding preexposure prophylaxis (PrEP), a daily medicine to prevent HIV, to our preventive care benefits starting July 1, 2020. This change eliminates cost-sharing for members, making PrEP more affordable for your patients at a higher risk of HIV acquisition.
Here’s what you need to know to help your patients make use of their new benefit.
Who’s covered
Premera will begin rolling out the benefit to our members starting July 1, 2020. Some members won’t receive the benefit until their plan renewal, so it's important for members to check their benefits before filling PrEP prescriptions.
Medication options
Our preventive benefits cover both Truvada (emtricitabine-tenofovir disoproxil fumarate) and Descovy (emtricitabine-tenofovir alafenamide). However, members will only receive Descovy at $0-member cost-share if they first tried Truvada in the last 2 years. A generic version of Truvada is expected to be available by the end of 2020.
Resources
- The addition of PrEP to our preventive care benefits is in response to a federal recommendation from the U.S. Preventive Services Task Force (USPSTF).
- You can find the Premera PrEP policy and other preventive care medical policies on our Medical Policies page for providers.