Can I Get PrEP Without Insurance?

The fastest path for uninsured people is a free telehealth platform. These services combine three things: a prescribing provider, an at-home lab kit, and direct medication delivery. The business model uses the federal 340B Drug Pricing Program plus Gilead's manufacturer assistance program to zero out your cost — you're not being charged behind the scenes, and you're not racking up debt.

MISTR is the most established option. It serves all 50 states plus DC and Puerto Rico, doesn't require insurance, ID, or a Social Security number, and has served over 500,000 patients. You fill out an intake form, receive an at-home HIV/STI test kit by mail, have a brief video consult, and the medication ships to your door in about a week.

Freddie (gofreddie.com) is free for over 90% of patients and focuses on men and transmasculine individuals. Q Care Plus (qcareplus.com) partners with community-based organizations and is usually free for uninsured people.

Nurx and PlushCare also prescribe PrEP but charge consultation fees without insurance, so they're worse choices if cost is your priority.

Gilead is the manufacturer of Descovy, brand Truvada, and the new long-acting injectable Yeztugo (lenacapavir). Its Advancing Access patient assistance program gives qualifying uninsured Americans these medications completely free. This is what most non-telehealth providers use to zero out your cost.

Eligibility:

• You are uninsured (no private insurance, no Medicaid, no Medicare prescription coverage)
• Your income is at or below 500% of the federal poverty level (roughly $78,000 for a single person, $106,000 for a household of two in 2025 figures)
• You live in the United States or a US territory

What's not required: a Social Security number, proof of citizenship, a specific immigration status, or a previous relationship with Gilead.

How to apply: Call Gilead's program at 1-800-226-2056 (Monday–Friday, 9 AM to 8 PM ET) or apply online at gileadadvancingaccess.com. You'll need your prescriber's contact information ready. Approvals are often same-day, and medication ships to your prescriber's pharmacy or directly to you.

If you don't already have a PrEP prescriber, use a free telehealth platform (Pathway 1) to get the prescription, then apply to Advancing Access separately — or let the telehealth platform handle the Gilead paperwork for you, which is how MISTR and similar services zero out your cost.

Twelve US jurisdictions operate dedicated PrEP Drug Assistance Programs. Unlike Gilead's program, many state DAPs cover not just medication but also labs, clinical visits, and — in some states — STI treatment and insurance premium support. If you live in one of these states, this is often the most comprehensive free option:

• California — CA PrEP-AP, up to 500% FPL, covers meds, labs, visits, STI treatment
• Colorado — up to 500% FPL, comprehensive coverage
• District of Columbia — DC Health Pharmacy Benefits Program
• Illinois — meds, labs, visits via state ADAP
• Indiana — comprehensive HIV health insurance plans at no cost
• Iowa — statewide TelePrEP navigation via University of Iowa
• Massachusetts — MA HDAP, up to 500% FPL (~$79,800 individual)
• New Mexico — medication plus clinical services
• New York — clinical services including STI, primary care
• Oklahoma — OSDH PrEP Program, (405) 426-8400, comprehensive coverage
• Virginia — meds, labs, visits
• Washington — WA DOH, generic PrEP plus labs and visits

If your state is on this list, start at your state page for the specific application number and income limit. If your state is not on this list (all Deep South states, most of the Midwest, and most of the Mountain West), the other pathways on this page are your primary options — this is the main gap in American PrEP infrastructure.

Federally Qualified Health Centers are federally funded safety-net clinics required by law to provide care regardless of insurance, income, or immigration status. There are roughly 1,400 FQHC organizations operating at over 15,000 sites across the United States — which means there is almost certainly one within driving distance of you.

FQHCs use a sliding fee scale tied to federal poverty level. Below 100% FPL, most patients pay nothing at all. Between 100% and 200% FPL, the fee is nominal (often $20–$40 per visit). FQHCs also frequently participate in the 340B Drug Pricing Program, which lets them dispense PrEP at steeply discounted prices — usually $0 after layering Gilead's assistance program on top.

What they cover: PrEP prescribing, quarterly HIV and STI testing, kidney function labs, and ongoing care. Many FQHCs also have in-house PrEP navigators who will handle the Gilead application paperwork for you.

How to find one: Use the HRSA Health Center finder at findahealthcenter.hrsa.gov. Call ahead and ask specifically for a PrEP provider — not every clinician at every FQHC prescribes it.

If you're uninsured because you can't afford insurance — not because you're opting out — Medicaid is often the best long-term path. PrEP is covered at $0 in every state's Medicaid program, and Medicaid also covers the associated labs, clinical visits, and STI testing at $0. It also covers virtually every other medical need you might have.

In the 40 states plus DC that have expanded Medicaid, adults up to 138% of the federal poverty level qualify — roughly $21,000/year for a single person or $29,000/year for a two-person household. Enrollment is year-round; you don't need to wait for open enrollment.

In the 10 non-expansion states (Florida, Texas, Georgia, Alabama, Mississippi, South Carolina, Tennessee, Wisconsin, Kansas, Wyoming), eligibility is much stricter and many low-income adults fall into the "coverage gap" — too poor for marketplace subsidies, too high-income for their state's traditional Medicaid. If this is you, skip Medicaid and use Pathways 1, 2, and 4 instead.

How to enroll: Go to healthcare.gov or your state's health insurance marketplace. The application will automatically route you to Medicaid if you qualify.