PrEP prevents HIV with up to 99% effectiveness. Most Americans can get it at absolutely zero cost — but the landscape changed dramatically in 2025. This is the most complete, current guide to every free PrEP pathway in the United States.
This is the most straightforward path. Under the Affordable Care Act, most private insurance plans are required by law to cover PrEP at $0 cost-sharing — that includes the medication, clinical visits, and lab work.
The USPSTF gave PrEP a Grade A preventive recommendation in 2019 (updated 2023). This means most employer, marketplace, and individual insurance plans must cover:
All at $0 out-of-pocket. No copays, no deductibles, no coinsurance.
Some providers bill PrEP visits as "office visits" rather than preventive care, triggering copays. If you receive a bill, call your insurer and request it be reprocessed under the preventive services mandate with the relevant USPSTF recommendation codes.
A federal case in Texas is challenging the ACA's preventive services mandate. As of March 2026, the $0 coverage requirement remains in effect while the case is appealed. We're tracking this litigation and will update this page if anything changes.
Platforms like MISTR handle the insurance billing, labs, consultation, and delivery — all at $0. You never see a bill, never visit a pharmacy, and your PrEP ships to your door. They serve all 50 states.
Using this code helps keep FreePrEP.org running and helps us connect more people with free PrEP.
Start Free with MISTR →Affiliate referral — we may earn a small fee at no cost to you. Full disclosure
This is where the landscape changed most in 2025. The federal Ready, Set, PrEP program ended July 2025, and Gilead discontinued free generic Truvada in January 2025. But there are still real pathways to $0 PrEP.
This is the single most important program for uninsured PrEP access. Gilead provides brand-name Descovy or Yeztugo completely free to qualifying patients:
prep.advancingaccess.com — or call 1-800-226-2056
Gilead MAP provides the pills/injections — but you still need a prescription, lab work, and clinical visits. This is where telehealth platforms and FQHCs come in (see below).
Platforms like MISTR partner with 340B-eligible health centers. For uninsured patients, the 340B surplus from insured patients cross-subsidizes your care. This means truly $0 for everything — the consultation, lab kits shipped to your home, and the medication delivered to your door.
See our full provider comparison for details on each platform.
Nearly 1,400 FQHCs across ~15,000 sites serve patients on a sliding fee scale based on income. Many prescribe PrEP and can connect you with medication assistance programs. You can never be turned away for inability to pay.
Find one near you: findahealthcenter.hrsa.gov
Here's a frustrating gap: Gilead's MAP only covers brand-name Descovy and Yeztugo — not generic TDF/FTC (generic Truvada). Since Ready, Set, PrEP ended and Gilead stopped providing free Truvada, there is no national program providing free generic PrEP.
If you specifically need generic PrEP, your options are limited to the 12 states with PrEP Drug Assistance Programs, FQHCs with 340B pricing, or GoodRx coupons (which bring generic TDF/FTC to roughly $30–$50/month).
Our recommendation: If you qualify for Gilead MAP, take the free brand-name Descovy. It's a better drug (fewer kidney and bone side effects) and it costs you nothing.
MISTR provides free PrEP including medication, at-home lab kits, and telehealth consultations in all 50 states. Insured or uninsured, you pay $0. They navigate Gilead MAP enrollment for you.
Using this code helps keep FreePrEP.org running and helps us connect more people with free PrEP.
Start Free with MISTR →Affiliate referral — we may earn a small fee at no cost to you. Full disclosure
All state Medicaid programs cover PrEP medication. Most also cover the associated lab work and clinical visits, though the extent of coverage varies by state.
In most cases, your copay will be $0 to $3. Medicaid covers generic TDF/FTC, Descovy, and increasingly Apretude and Yeztugo (though injectable coverage may require prior authorization).
The One Big Beautiful Bill Act (signed July 4, 2025) imposed new Medicaid work requirements and tightened immigrant eligibility in many states. If you've been disenrolled or are at risk of losing Medicaid coverage, check your state's page for current eligibility rules and re-enrollment options.
Important: Gilead copay cards and manufacturer copay assistance cannot be used with Medicaid or other government insurance. However, Gilead MAP can sometimes be used alongside Medicaid for medication if your Medicaid plan won't cover a particular formulation.
Medicare covers PrEP, but the cost-sharing situation is more complicated than private insurance or Medicaid.
Under Medicare Part D, PrEP medications are covered, but you may face copays depending on your plan's formulary tier and where you are in the coverage phases. The ACA preventive services mandate applies differently to Medicare — lab work and clinical visits related to PrEP should be covered at $0 under Medicare Part B preventive benefits.
Gilead copay cards cannot be used with Medicare. This is a significant gap. Your best options:
Two injectable PrEP options are now FDA-approved, eliminating the need for a daily pill. See our complete injectable PrEP guide for full details.
Approved June 2025 by Gilead Sciences. A subcutaneous injection every 6 months after initial oral loading doses. The PURPOSE clinical trials demonstrated extraordinary efficacy — 100% risk reduction in cisgender women (PURPOSE 1) and 96% risk reduction in the diverse PURPOSE 2 population.
Cost: List price ~$28,218/year. Covered by Gilead Advancing Access: free via MAP for eligible uninsured patients, and up to $8,000/year in copay assistance plus $100/visit for injection administration for commercially insured patients.
prep.advancingaccess.com/injectables — or call 1-800-226-2056
Approved December 2021 by ViiV Healthcare. An intramuscular injection every 2 months after an initial loading phase. List price ~$4,038/injection (~$24,000/year).
Free access: ViiVConnect Patient Assistance Program provides free Apretude to uninsured patients with income under 500% FPL. The APRETUDE Savings Program reduces copays to $0 for commercially insured patients.
viivconnect.com — savings and patient assistance
Access to PrEP without documentation is harder than it should be, but real options exist.
This is critical — Gilead's Medication Assistance Program explicitly accepts undocumented residents. If you earn under 500% FPL, you can receive free brand-name Descovy or Yeztugo regardless of immigration status. Apply at prep.advancingaccess.com or call 1-800-226-2056.
Using PrEP or healthcare services at FQHCs does not count against you under the public charge rule. Preventive healthcare, including PrEP, is explicitly excluded from public charge determinations. However, enrollment fears have increased — surveys show 46% of likely undocumented immigrants avoided government programs in 2025, up from 27% in 2023.
Only 12 states and DC run dedicated PrEP Drug Assistance Programs (DAPs). If you live in one of these states, you may have an additional safety net. See our full state-by-state directory for details.
| State | Covers | Income limit |
|---|---|---|
| California | Medication + labs + visits + STI treatment | 500% FPL |
| Colorado | Medication + labs + visits | 500% FPL |
| District of Columbia | Medication + labs + visits | Not published |
| Illinois | Medication + labs + visits | Not published |
| Indiana | Medication + labs + visits | Not published |
| Iowa | Medication + labs + visits | Not published |
| Massachusetts | Full medication cost or copays | 500% FPL |
| New Mexico | Medication + clinical services | Not published |
| New York | Clinical services (testing, counseling, STI) | Need-based |
| Oklahoma | Medication + labs + visits | Not published |
| Virginia | Medication + labs + visits | Not published |
| Washington | Generic PrEP + labs + visits | Income-based |
The remaining 38+ states have no dedicated PrEP DAP. This gap is particularly damaging in the US South, which bears the highest HIV burden. If you live in a non-DAP state, your primary options are Gilead MAP, telehealth platforms, and FQHCs.
If you have insurance but still face copays, these programs can bring your costs to $0:
Up to $7,200/year for commercially insured patients on Descovy or Yeztugo. No income restriction. Cannot be used with government insurance.
Up to $7,500/year for insured patients under 400% FPL. Call 1-866-512-3861. Merging with PAN Foundation — "TotalAssist" launches July 2026.
Up to $7,500/year, primarily for Medicare/military beneficiaries under 500% FPL. SSN required. Fund opens and closes periodically — check availability at mygooddays.org.
Currently closed. Merging with Patient Advocate Foundation — unified "TotalAssist" program expected July 1, 2026.
Check our program status tracker for real-time updates on which funds are open or closed.
Platforms like MISTR, Q Care Plus, and Freddie offer PrEP at $0 to many patients. Here's the honest explanation of how this is economically possible:
Federal law requires drug manufacturers to sell medications at steep discounts (25–50% below average price) to eligible healthcare entities — Federally Qualified Health Centers, Ryan White clinics, and disproportionate share hospitals. These "covered entities" partner with telehealth platforms.
When an insured patient gets PrEP through these partnerships, the covered entity purchases the drug at the discounted 340B price but bills insurance at the standard reimbursement rate. The spread generates significant revenue — estimated at $900–$2,200 per Descovy prescription. This surplus funds free care for uninsured patients.
This isn't always in the patient's interest, but it's worth understanding: brand Descovy generates a much larger 340B margin than generic TDF/FTC. Platforms that rely on 340B revenue have a financial incentive to prescribe brand drugs. That said, Descovy does have genuine clinical advantages — fewer kidney and bone density side effects — so the recommendation often aligns with good medicine.
See our full telehealth provider comparison for a detailed breakdown of what each platform offers, their costs, state availability, and whether they serve uninsured patients.
Three major shifts reshaped PrEP access in 2025:
The HHS program that provided free PrEP medication to uninsured patients stopped accepting new enrollments on July 30, 2024 and fully shut down on July 18, 2025. No replacement federal program has been established. Read more →
Gilead stopped providing free generic TDF/FTC (Truvada) through its Advancing Access program, citing broad generic availability. This created a gap: brand Descovy is free for qualifying patients, but cheaper generic PrEP has no manufacturer assistance.
The first twice-yearly injectable PrEP hit the market, offering six months of protection per injection. Clinical trials showed unprecedented efficacy. Read more →
Additionally, the One Big Beautiful Bill Act (signed July 4, 2025) imposed roughly $800 billion in Medicaid cuts including work requirements and tighter immigrant eligibility, further restricting access for vulnerable populations.
Our eligibility tool asks a few quick questions and matches you with every program you qualify for.
Find My Free PrEP Path