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Freddie vs MISTR: Which Free PrEP Service Is Better in 2026?

Freddie and MISTR are the two largest telehealth platforms offering free PrEP in all 50 states. Both cover consultations, labs, medication, and delivery — so how do you actually choose between them? We compared them on everything that matters.

Side-by-Side Comparison

FeatureMISTRFreddie
Cost to you$0 — insured and uninsured$0 for 90%+ of patients
CoverageAll 50 states + DC + Puerto RicoAll 50 states (via ASHA partnership)
Patients served500,000+47,000+ consultations completed
Founded2018 (Miami Beach, FL)2020 (Calgary, Canada; US launch 2024)
At-home labsYes — at-home kits or 2,200+ partner labsYes — at-home kits shipped free
MedicationsGeneric TDF/FTC and brand DescovyGeneric TDF/FTC and brand Descovy
DoxyPEPYes — available alongside PrEPYes — available alongside PrEP
Injectable PrEPOral only (as of mid-2026)Oral only (as of mid-2026)
Uninsured supportFull coverage via 340B + PAP navigationPAP navigation + CBO partnerships
Consultation styleVideo consult with assigned physicianVideo or phone consult with clinician
DeliveryFree, discreet shippingFree, discreet shipping
Trustpilot ratingNot listed on Trustpilot4.8 stars (460+ reviews)
Business model340B drug pricing reinvestment340B CBO partnerships

Try MISTR — $0 PrEP in every state

Free consultation, free at-home labs, free medication, free delivery. MISTR covers everything whether you have insurance or not. Takes about 5 minutes to start.

ANDR735

Using this code at signup helps keep FreePrEP.org running and supports our mission to help everyone access PrEP for free.

How Both Platforms Offer Free PrEP

Both MISTR and Freddie use the federal 340B Drug Pricing Program to offer PrEP at no cost. Here's the short version: they partner with eligible healthcare organizations that can purchase medications at steep discounts. When your insurance reimburses the prescription at normal rates, the difference funds free care for everyone — including uninsured patients.

This is why both platforms can legitimately offer $0 PrEP. It's not a limited-time promotion or bait-and-switch. The model is sustainable because insured patients generate enough margin to cross-subsidize uninsured care.

MISTR has built its own extensive 340B network and reinvests savings directly. A 2025 Emory University study published in JAMA found that roughly 1 in 5 Americans on PrEP receive it through MISTR's platform. More than one-third of MISTR users are uninsured.

Freddie partners with community-based organizations (CBOs) like EPIC, ASHA, LGBT Life Center, and Edge New Jersey. These partnerships let Freddie access 340B pricing through established covered entities. Freddie reports saving partner organizations over $10 million to date.

MISTR — Pros and Cons

Strengths

  • Largest US PrEP telehealth platform (500,000+ patients)
  • Covers uninsured patients completely — no cost, no catches
  • 2,200+ partner lab locations if you prefer in-person testing
  • Available in DC and Puerto Rico (not just 50 states)
  • Established track record since 2018

Limitations

  • Oral PrEP only — no injectable (Apretude/Yeztugo) yet
  • Tends to prescribe brand Descovy (higher 340B margins) over generics
  • No Trustpilot presence — harder to find independent reviews

Freddie — Pros and Cons

Strengths

  • Excellent user reviews (4.8 stars on Trustpilot, 460+ reviews)
  • Founded by physicians (Dr. Husein Moloo and Dr. Caley Shukalek)
  • Strong partnerships with community organizations
  • Phone or video consultation options
  • Also serves Canada — useful for cross-border patients

Limitations

  • Newer to the US market (launched 2024) — smaller patient base
  • $0 for "90%+ of patients" rather than guaranteed $0 for everyone
  • No Puerto Rico coverage confirmed
  • Oral PrEP only — no injectable options yet

Get started with MISTR in 5 minutes

Complete a brief health questionnaire, get at-home labs shipped, consult with a physician, and have your PrEP medication delivered — all at $0.

ANDR735

Using this code at signup helps keep FreePrEP.org running and supports our mission to help everyone access PrEP for free.

Our Recommendation

Choose MISTR if...

You want the largest, most established platform with guaranteed $0 cost whether or not you have insurance. MISTR's scale means more provider experience, more lab locations, and a proven track record with over 500,000 patients. If you're uninsured, MISTR is the safer bet — they've been handling PAP enrollment and 340B navigation since 2018.

Choose Freddie if...

You value physician-founded care and want a platform with excellent independently verified reviews. Freddie's smaller scale means a more personal experience, and their CBO partnerships support community health organizations directly. If you have insurance and want a provider with strong user satisfaction ratings, Freddie is a great option.

Bottom line: You can't go wrong with either. Both provide free PrEP, both ship medications to your door, and both handle the insurance and assistance program paperwork. The biggest practical differences are MISTR's larger scale and guaranteed $0 pricing for uninsured patients vs. Freddie's stronger independent reviews and physician-led approach.

If you want the broadest safety net and the most established service, go with MISTR. If you're insured and prioritize a personal touch, Freddie is worth considering.

What About Q Care Plus, Nurx, and Others?

Q Care Plus is another strong free option, offering $0 PrEP for 99% of insured patients through CBO partnerships. They don't cover all states and have limited uninsured support, but they're worth checking if MISTR and Freddie don't work for you.

Nurx charges $15–$30 per consultation plus lab fees, making it the most expensive telehealth PrEP option. Its parent company is also pivoting away from PrEP toward women's health — we'd consider it a less reliable long-term choice.

For a full breakdown of all platforms, see our PrEP provider comparison page.

Frequently Asked Questions

Is MISTR actually free?
Yes. MISTR covers the consultation, at-home lab kit, medication, and delivery at $0 for both insured and uninsured patients. They use 340B drug pricing and manufacturer patient assistance programs to cover the costs. There are no hidden fees. See our full MISTR review for details.
Is Freddie actually free?
For over 90% of patients, yes. Freddie reports that the vast majority of their patients pay $0 for PrEP, including consultation, labs, and medication delivery. If you're uninsured, Freddie will help navigate patient assistance programs to cover costs. A small percentage of patients may have some out-of-pocket cost depending on their insurance situation.
Can I switch from Freddie to MISTR (or vice versa)?
Yes. You can switch telehealth PrEP providers at any time. You'll need to complete a new consultation and lab work with the new provider, but there's no penalty or waiting period. Make sure your current prescription doesn't lapse during the transition.
Do either offer injectable PrEP (Apretude or Yeztugo)?
Neither MISTR nor Freddie currently offers injectable PrEP. Both platforms provide oral PrEP only (generic TDF/FTC and Descovy). Injectable PrEP requires in-person administration, which doesn't fit the telehealth model. See our injectable PrEP guide for access options.
Which is better for uninsured patients?
MISTR has a stronger track record with uninsured patients. Over one-third of their users are uninsured, and they guarantee $0 cost regardless of insurance status. Freddie also supports uninsured patients through PAP navigation, but their "$0 for 90%+ of patients" language leaves slightly more ambiguity.

Ready to start PrEP?

MISTR makes it simple — free consultation, free labs, free medication, free delivery. All 50 states, DC, and Puerto Rico. No insurance required.

ANDR735

Using this code at signup helps keep FreePrEP.org running and supports our mission to help everyone access PrEP for free.

Related Guides

Information sourced from MISTR (heymistr.com), Freddie (gofreddie.com), JAMA Network Open, NASTAD, and CDC. FreePrEP.org is an independent resource — not affiliated with any government agency, pharmaceutical company, or telehealth provider. Full disclosure