In this guide
At-a-Glance Pricing Table With Private Insurance With Medicaid With Medicare Without Insurance Injectable PrEP Costs Copay & Assistance Programs Telehealth: The Easiest Path to $0 Frequently Asked Questions2026 PrEP Pricing at a Glance
Four FDA-approved PrEP medications are currently available in the United States. Their list prices vary enormously — but what you actually pay depends on your insurance and whether you qualify for assistance programs.
| Medication | List Price | With Insurance | Discount Coupon | With Assistance |
|---|---|---|---|---|
| Generic TDF/FTC Generic Truvada · Daily pill | $1,682/mo retail | $0 | $27–$60/mo | $0 (no manufacturer PAP) |
| Descovy Brand · Gilead · Daily pill | $2,202/mo | $0 | $2,148–$2,944/mo | $0 via Gilead MAP |
| Apretude Cabotegravir · ViiV · Injection every 2 months | ~$4,038/injection ~$24,000/yr |
$0 | N/A | $0 via ViiV PAP |
| Yeztugo Lenacapavir · Gilead · Injection every 6 months | $28,218/yr | $0 | N/A | $0 via Gilead MAP |
Sources: GoodRx (April 2026), Gilead price info, ViiV Healthcare. Generic TDF/FTC coupon prices from GoodRx. "With Insurance" reflects ACA $0 cost-sharing mandate. "With Assistance" reflects manufacturer Patient Assistance Programs for uninsured patients ≤500% FPL.
With Private Insurance: $0
The ACA mandate covers everything
Under the Affordable Care Act, private insurance plans must cover PrEP with zero cost-sharing. This includes the medication itself, all required lab work (HIV tests, kidney function, STI screening), and clinical visits. This was confirmed by the Supreme Court in Kennedy v. Braidwood Management in June 2025.
This applies to all FDA-approved PrEP medications — generic TDF/FTC, Descovy, Apretude, and Yeztugo. Your insurer cannot charge a copay, coinsurance, or deductible for PrEP.
Getting charged anyway?
Some insurers still try to charge copays or require prior authorization. If this happens to you, call your insurer and cite the ACA preventive services mandate (Section 2713 of the PHS Act). If they don't fix it, file a complaint with your state insurance commissioner or the HHS Office for Civil Rights. You are legally entitled to $0 PrEP.
Note: Some plans may require you to try generic TDF/FTC before covering Descovy (called "step therapy"). This is legally contested but still practiced by some insurers.
Even if your plan somehow charges a copay, Gilead's copay savings card covers up to $7,200/year for commercially insured patients on Descovy or Yeztugo. ViiV's savings card reduces Apretude copays to $0. There's no reason to pay out of pocket for PrEP with private insurance.
With Medicaid: $0
Every state Medicaid program covers PrEP
Medicaid covers PrEP at $0 cost-sharing in all 50 states and DC. Generic TDF/FTC typically requires no prior authorization. Brand-name medications (Descovy, Apretude) may require prior authorization in some states, but coverage is guaranteed.
40 states plus DC have expanded Medicaid under the ACA. If you earn up to 138% of the Federal Poverty Level (~$20,783/year for an individual), you likely qualify for Medicaid. Apply through your state marketplace or healthcare.gov.
Important for telehealth users: Most online PrEP platforms (MISTR, Nurx, etc.) do not accept Medicaid. If you have Medicaid, your best option is an in-person provider — a Federally Qualified Health Center (FQHC), your local health department, or a PrEP-prescribing clinic. Find one at preplocator.org.
With Medicare: Low Cost or $0
Covered under Part D with cost-sharing
Medicare Part D covers PrEP medications. Oral PrEP (generic TDF/FTC and Descovy) typically costs $0–$9/month depending on your plan and whether you qualify for the Extra Help (Low-Income Subsidy) program. Injectable PrEP (Apretude, Yeztugo) may be covered under Medicare Part B as a medical benefit.
If you have a Medicare Advantage plan, check your formulary — coverage varies by plan.
Reducing Medicare costs further
The Good Days Foundation offers up to $7,500/year in copay assistance specifically for Medicare and military beneficiaries earning under 500% FPL. Call 1-877-968-7233. Note: SSN is required for this program.
Gilead's copay savings card is not available for Medicare, Medicaid, or other government-insured patients.
Without Insurance: Still $0 for Most People
This is where the sticker prices look terrifying — but here's the reality: the majority of uninsured Americans qualify for free PrEP through manufacturer programs. Here's how, step by step.
Check if your state has a PrEP Drug Assistance Program (DAP). About 12 states operate PrEP-specific programs that cover medication, labs, and clinical visits for uninsured residents. Income limits are typically 200–500% FPL. Find your state's program →
Apply to Gilead Advancing Access. This is the single most important program for uninsured PrEP users. It provides free Descovy, Truvada, and Yeztugo to uninsured patients earning under 500% FPL (~$79,800/year for an individual). SSN is not required — undocumented residents are explicitly eligible. Medication ships via FedEx overnight. Call 1-800-226-2056 or visit gileadadvancingaccess.com.
For Apretude (cabotegravir), contact ViiV Healthcare. The ViiVConnect Patient Assistance Program provides free Apretude to uninsured patients under 500% FPL. Call 1-844-588-3288.
For labs and clinic visits, use a Federally Qualified Health Center (FQHC). FQHCs serve all patients regardless of ability to pay or immigration status, using a sliding fee scale. Manufacturer programs cover the medication — FQHCs cover everything else. Find one at findahealthcenter.hrsa.gov.
Or skip all of the above and use MISTR. MISTR provides free PrEP — medication, labs, and consultations — in all 50 states through 340B drug pricing partnerships. Insured or uninsured, you pay nothing. Get started at heymistr.com →
One gap to know about
Gilead discontinued free brand-name Truvada through Advancing Access on January 31, 2025 — but generic TDF/FTC has no manufacturer assistance program. This means if you're uninsured and want the cheapest oral PrEP (generic), you'd pay $27–$60/month with a discount coupon. But if you apply to Gilead Advancing Access, you can get brand-name Descovy for free instead — which is actually the better deal.
Injectable PrEP Costs
Injectable PrEP eliminates the daily pill — but the list prices are eye-watering. Here's what you'd actually pay.
Apretude (Cabotegravir) — Every 2 Months
List price: ~$4,038 per injection (~$24,000/year). Requires an intramuscular injection at a provider's office every 2 months after a loading phase.
With private insurance: $0 under the ACA. The ViiV Savings Card also covers copays to $0.
Without insurance: Free through ViiVConnect PAP for patients under 500% FPL. Call 1-844-588-3288.
Good to know: Apretude is not approved for people at risk solely from receptive vaginal sex (same limitation as Descovy). ViiV maintains an Alternate Sites of Care network to help you find an injection location.
Yeztugo (Lenacapavir) — Twice a Year
List price: $28,218/year. A subcutaneous injection given every 6 months after an oral loading phase — the longest dosing interval of any PrEP.
With private insurance: $0 under the ACA. Gilead's copay card covers up to $7,200/year.
Without insurance: Free through Gilead Advancing Access for patients under 500% FPL. Call 1-800-226-2056.
Good to know: FDA-approved June 2025. Clinical trials (PURPOSE 1 & 2) showed extraordinary efficacy — 100% risk reduction in cisgender women and 96% in a diverse population. Yeztugo is approved for all populations at risk of HIV, including those at risk from receptive vaginal sex.
For a full comparison of injectable PrEP options including dosing schedules, side effects, and access programs, see our Complete Injectable PrEP Guide.
Every PrEP Assistance Program (2026)
Beyond insurance and manufacturer programs, several nonprofit foundations can help cover remaining copays and costs.
Gilead Advancing Access
Free medication
Free Descovy, Truvada, or Yeztugo for uninsured patients ≤500% FPL. SSN not required.
1-800-226-2056
Gilead Copay Savings Card
Up to $7,200/yr
For commercially insured patients on Descovy or Yeztugo. No income restrictions.
1-877-505-6986
ViiVConnect PAP
Free Apretude
Free cabotegravir injections for uninsured patients ≤500% FPL.
1-844-588-3288
ViiV Savings Card
$0 copay
Reduces Apretude copays to $0 for commercially insured patients.
1-844-588-3288
Patient Advocate Foundation
Up to $7,500/yr
Copay assistance for insured patients ≤400% FPL. Merging with PAN Foundation into "TotalAssist" on July 1, 2026.
1-866-512-3861
Good Days Foundation
Up to $7,500/yr
Primarily for Medicare/military beneficiaries ≤500% FPL. SSN required.
1-877-968-7233
PAN Foundation
Currently closed
HIV/PrEP fund is currently closed. Merging with PAF into "TotalAssist" launching July 1, 2026.
State PrEP DAPs
Varies by state
~12 states operate PrEP assistance programs covering meds, labs, and visits for uninsured residents.
The fastest path to $0 PrEP
MISTR provides free PrEP — medication, labs, and consultations — in all 50 states. Insured or uninsured, you pay nothing. Everything ships to your door.
Start Free PrEP with MISTR →
Use code ANDR735 at signup. Using this code helps keep FreePrEP.org running and supports free PrEP access for everyone.
How MISTR makes PrEP free
MISTR partners with 340B-eligible covered entities — federally funded clinics that purchase medications at steep discounts under the 340B Drug Pricing Program. This allows them to provide PrEP at no cost to patients regardless of insurance status. Your consultation, lab work, and medication are all included.
To get started, visit heymistr.com and use referral code ANDR735 at signup.
Frequently Asked Questions
Without insurance, the list price depends on the medication. Generic TDF/FTC costs as little as $27–$60/month with a GoodRx or SingleCare coupon. Descovy is $2,200–$2,944/month. Apretude runs about $4,038 per injection. Yeztugo is $28,218/year.
However, most uninsured Americans qualify for free PrEP through manufacturer patient assistance programs (Gilead Advancing Access or ViiVConnect) if their income is below 500% of the Federal Poverty Level (~$79,800/year). Telehealth platforms like MISTR also provide PrEP at no cost.
Yes. Under the ACA, private insurance plans must cover PrEP at $0 cost-sharing — including the medication, lab work, and clinical visits. This was confirmed by the Supreme Court in Kennedy v. Braidwood Management (June 2025). Medicaid also covers PrEP at $0 in all states.
Several pathways exist. Gilead Advancing Access provides free Descovy, Truvada, or Yeztugo for uninsured patients under 500% FPL (call 1-800-226-2056). ViiVConnect provides free Apretude (call 1-844-588-3288). Many states operate PrEP Drug Assistance Programs. And telehealth platforms like MISTR provide complete free PrEP services — medication, labs, and consultations — in all 50 states.
Descovy's list price is $2,202/month — but most people pay $0. With private insurance, it's covered at no cost under the ACA. Gilead's copay savings card covers up to $7,200/year for commercially insured patients. Uninsured patients earning under 500% FPL can get Descovy free through Gilead Advancing Access (1-800-226-2056).
Apretude (cabotegravir) costs about $4,038 per injection, given every 2 months — roughly $24,000/year. Yeztugo (lenacapavir) costs about $28,218/year for twice-yearly injections. Both have $0 copay programs for insured patients and free patient assistance programs for uninsured patients under 500% FPL.
Generic TDF/FTC (generic Truvada) is the cheapest PrEP medication — as low as $27/month with a pharmacy discount coupon. However, with insurance, all PrEP options are $0. And uninsured patients qualifying for manufacturer assistance can get even expensive injectables for free.
Not yet in the United States. As of early 2026, Descovy (emtricitabine/tenofovir alafenamide) remains brand-name only from Gilead Sciences. A generic has been approved in Europe but is not yet commercially available in the U.S. Generic Truvada (TDF/FTC) is widely available from multiple manufacturers.
The federal Ready, Set, PrEP program ended in July 2025 and is no longer accepting enrollees. Gilead Advancing Access, state PrEP DAPs, and telehealth platforms like MISTR have largely replaced it as pathways to free PrEP for uninsured Americans. Read our full explainer →