PrEP (pre-exposure prophylaxis) prevents HIV with up to 99% effectiveness. For most Americans, it can be obtained at absolutely zero cost — but navigating the system has gotten harder since mid-2025.
The federal Ready, Set, PrEP program ended in July 2025. Gilead discontinued its free Truvada patient assistance program in January 2025. And the July 2025 budget legislation imposed significant Medicaid restrictions. Meanwhile, a revolutionary twice-yearly injectable (Yeztugo) was approved in June 2025 and has rapidly gained insurance coverage.
The result: a fractured landscape where dozens of websites still reference defunct programs while new options go unadvertised. This guide covers every current pathway to free PrEP, updated monthly.
Short on time? Use our free eligibility tool — answer 4 questions and get personalized results in under 60 seconds.
Federal funding under pressure: In early 2025, the CDC eliminated five HIV prevention branches and terminated approximately $600 million in HIV and STD grants to several states. Congress preserved level HIV prevention funding in the final FY2026 appropriations bill, but grant disruptions have already impacted community organizations that provide PrEP navigation and testing services in many areas.
If You Have Private Insurance
This is the simplest path. Under the Affordable Care Act, most private insurance plans must cover PrEP at $0 cost-sharing — that means no copay, no coinsurance, and no deductible for the medication, lab work, and clinical visits.
This coverage comes from the USPSTF Grade A recommendation for PrEP (first issued in 2019, updated in 2023). It applies to employer-sponsored plans, ACA marketplace plans, and most individual plans. The only exceptions are grandfathered plans and some religious employer exemptions.
Legal update — good news: In June 2025, the Supreme Court ruled 6–3 in Kennedy v. Braidwood Management (606 U.S. 748) that the ACA's preventive services mandate is constitutional, preserving the $0 PrEP coverage requirement for the roughly 150 million Americans with private insurance. The Court held that USPSTF members are properly appointed inferior officers. Two caveats remain: religious exemption claims (RFRA) were remanded to the district court for further proceedings, and the ACIP/HRSA questions about vaccine and women's health recommendations are still unresolved. But the core $0 PrEP mandate is settled law.
What to do
If you have private insurance, you have two main approaches:
Option A: Go through your regular doctor. Ask your primary care provider or an HIV specialist for a PrEP prescription. They'll order the required lab work (kidney function, HIV test, STI screening). Your insurance should cover everything at $0. If your pharmacy charges a copay, the Gilead Copay Savings Program (below) can cover it.
Option B: Use a telehealth platform. Services like MISTR handle everything — the consultation, lab orders (at-home kits shipped to you), the prescription, and insurance billing. You never deal with claims or paperwork. For many people, this is the easiest path.
MISTR — $0 Telehealth PrEP (All 50 States)
MISTR handles your insurance billing through 340B pharmacy partnerships, so you pay $0 for medication, labs, and consultations. At-home lab kits, medication delivered to your door, and ongoing monitoring included. Available in all 50 states plus DC and Puerto Rico.
Start with MISTR (code ANDR735)Gilead Copay Savings Program
If your insurance charges any out-of-pocket cost for Descovy or Yeztugo, this program covers up to $7,200/year for oral PrEP or $8,000/year for Yeztugo (plus $100/visit for injection administration). No income restriction. Cannot be combined with government insurance (Medicaid, Medicare, TRICARE).
Get the copay cardPatient Advocate Foundation — Copay Relief
Up to $7,500/year in copay assistance for commercially insured patients with household income under 400% FPL (~$63,800/year for a single person). This can cover any remaining out-of-pocket costs after insurance. Call 1-866-512-3861.
Coming soon: PAF and the PAN Foundation are merging, with a unified TotalAssist program launching July 1, 2026. TotalAssist will combine 130+ disease-specific funds with instant eligibility decisions and concierge support. We'll update this section when the new enrollment portal goes live.
Apply at PAFIf You Have No Insurance
Losing Ready, Set, PrEP and Gilead's free Truvada program in 2025 hit uninsured individuals the hardest. But free PrEP is still available through several pathways — you just need to know where to look.
Path 1: Telehealth platforms (fastest, easiest)
Platforms like MISTR provide completely free PrEP to uninsured patients through partnerships with 340B-eligible healthcare organizations. The 340B program allows these organizations to purchase medications at steep discounts and cross-subsidize uninsured care with revenue from insured patients. The result: $0 PrEP for you, including medication, labs, and consultations.
MISTR — $0 PrEP for the Uninsured
Even without insurance, MISTR provides free PrEP — medication, labs, and consultations — in all 50 states. They navigate manufacturer assistance programs on your behalf and cover remaining costs through 340B partnerships. Over 500,000 patients served.
Start free PrEP with MISTRPath 2: Gilead Advancing Access (Medication Assistance Program)
Gilead's MAP provides free brand-name Descovy or Yeztugo to uninsured patients with income at or below 500% FPL (~$79,800/year for a single person). Key details:
- No Social Security Number required — undocumented residents are explicitly eligible
- Medication ships via FedEx overnight to a home, clinic, shelter, or FedEx location
- Covers medication only — you still need a provider for the prescription and lab work
- Call 1-800-226-2056 or apply online
Important: Gilead discontinued free generic Truvada (TDF/FTC) through Advancing Access on January 31, 2025. The MAP now covers only brand-name Descovy and Yeztugo. If you need generic PrEP specifically, your options are state PrEP DAPs (if your state has one) or 340B-based telehealth platforms.
Gilead Advancing Access — Medication Assistance Program
Free Descovy or Yeztugo for uninsured patients under 500% FPL. No SSN required. Overnight delivery available.
Apply at Advancing AccessPath 3: Federally Qualified Health Centers
Nearly 1,400 FQHCs at approximately 15,000 sites nationwide offer sliding-fee services based on income. They can prescribe PrEP, perform lab work, and connect you to assistance programs — even if you're uninsured or undocumented. Fees are based on your ability to pay, and no one is turned away.
Find a Health Center Near You
HRSA's Health Center Finder locates FQHCs and community health centers by zip code. Many offer PrEP services, STI testing, and primary care on a sliding-fee scale.
Find an FQHCPath 4: Get insured
If you're currently uninsured, getting an ACA marketplace plan would unlock $0 PrEP coverage under the preventive services mandate — now backed by the Supreme Court's June 2025 Kennedy v. Braidwood ruling. Many people qualify for subsidies that significantly reduce monthly premiums — in some cases to $0. Open enrollment runs November through mid-January each year, but qualifying life events (job loss, moving, marriage) can trigger a Special Enrollment Period.
If You Have Medicaid
Medicaid covers PrEP in all states, including medication, lab work, and clinical visits. Coverage details and any cost-sharing requirements vary by state. Some states require prior authorization for brand-name PrEP (Descovy) or injectable options (Apretude, Yeztugo) when cheaper generic alternatives exist.
The July 2025 budget legislation imposed new work requirements and tighter immigrant eligibility rules for Medicaid that may affect coverage in some states. If you're concerned about your Medicaid eligibility, contact your state Medicaid office or visit Medicaid.gov.
Telehealth platforms like MISTR accept Medicaid in most states and can handle billing so you pay nothing out of pocket.
If You Have Medicare
Medicare Part D covers PrEP medications. Starting in 2025, the Inflation Reduction Act capped Medicare Part D out-of-pocket costs at $2,000/year (rising to $2,100 in 2026), which means even without additional assistance, your annual PrEP costs are limited. Once you hit the cap, your plan covers 100% of remaining prescription costs for the year.
The challenge: manufacturer copay cards (Gilead, ViiV) cannot be used with government insurance, including Medicare. This leaves Medicare beneficiaries relying on nonprofit copay funds, which frequently open and close based on funding.
Good Days Foundation
Offers up to $7,500/year primarily for Medicare and military beneficiaries with income under 500% FPL. SSN is required. Fund availability fluctuates — check their website for current status.
Check fund statusThe Patient Advocate Foundation and PAN Foundation merged in March 2026 and are launching a unified TotalAssist program on July 1, 2026. TotalAssist will consolidate 130+ disease-specific financial assistance funds — including PrEP — with instant eligibility decisions and concierge support. Both organizations' existing programs remain active until the transition. Visit uniting.patientadvocate.org for updates.
Injectable PrEP Options
Two injectable PrEP medications are now FDA-approved, offering alternatives to the daily pill:
Yeztugo (lenacapavir) — Every 6 Months
Approved June 2025 by Gilead Sciences. A subcutaneous injection every 6 months after initial oral loading doses. The PURPOSE trials showed extraordinary efficacy — up to 100% risk reduction in cisgender women and 96% in the broader population. List price: ~$28,218/year.
Insurance coverage: As of early 2026, more than 85% of US insurers cover Yeztugo, including all three major pharmacy benefit managers (UnitedHealth/Optum Rx, Cigna/Express Scripts, and CVS Caremark). CVS Caremark was the last holdout, agreeing to coverage in January 2026. Note: the USPSTF has not yet specifically graded Yeztugo (its 2023 PrEP recommendation predated approval), so the ACA $0 cost-sharing mandate may not automatically apply — check with your plan, and use Gilead's copay program if needed.
Cost assistance: Gilead Advancing Access covers Yeztugo — free via MAP for uninsured patients under 500% FPL, or up to $8,000/year copay assistance plus $100/visit for commercially insured patients.
Apply for Yeztugo assistanceApretude (cabotegravir) — Every 2 Months
Approved December 2021 by ViiV Healthcare. An intramuscular injection every 2 months after an initial loading phase. List price: ~$24,000/year (~$4,038 per injection). Covered under most commercial, Medicaid, and Medicare plans as a medical benefit, though prior authorization is common.
Cost assistance: ViiVConnect provides free Apretude to uninsured patients under 500% FPL, plus a $0 copay savings card for commercially insured patients.
Apply at ViiVConnectFor a detailed comparison of injectable vs. oral PrEP — including side effects, efficacy data, and who each option is best for — see our complete injectable PrEP guide.
State PrEP Assistance Programs
Only 12 states (plus DC) operate dedicated PrEP Drug Assistance Programs. If you live in one of these states, you may have an additional pathway to free PrEP beyond the national programs listed above.
The remaining 38+ states have no dedicated PrEP assistance infrastructure — a gap that's particularly damaging in the South, which bears the highest HIV burden but has the fewest state programs.
| State | Covers | Income Limit | Notes |
|---|---|---|---|
| California | Meds + labs + visits + STI treatment | 500% FPL | Covers generic TDF directly for uninsured; caseload projected to nearly double in FY 2025-26 |
| Colorado | Meds + labs + visits | 500% FPL | Insured must apply for Gilead copay first |
| DC | Meds + labs + visits | Not published | DC Health Pharmacy Benefits Program |
| Illinois | Meds + labs + visits | Not published | Part of state ADAP infrastructure |
| Indiana | Meds + labs + visits | Not published | Comprehensive HIV health insurance at no cost |
| Iowa | Meds + labs + visits | Not published | TelePrEP navigation via University of Iowa |
| Massachusetts | Medication costs | 500% FPL | Administered by Community Research Initiative |
| New Mexico | Meds + clinical services | Not published | — |
| New York | Clinical services | Need-based | Medication via manufacturer PAPs |
| Oklahoma | Meds + labs + visits | Not published | — |
| Virginia | Meds + labs + visits | Not published | — |
| Washington | Generic PrEP + labs + visits | Income-based | Contracted providers/labs required |
For detailed information about your state's specific programs, eligibility, and how to apply, see our state-by-state PrEP directory.
Telehealth PrEP Providers Compared
Telehealth has become one of the most popular ways to access PrEP — an estimated 20% of all US PrEP users (~110,000 people) received PrEP via telehealth in 2024, according to a study published in JAMA Network Open. Here's how the major platforms compare:
| Platform | Cost | States | At-Home Labs | Injectable PrEP |
|---|---|---|---|---|
| MISTR | $0 (insured & uninsured) | 50 + DC + PR | Yes | Enrolling for Yeztugo |
| Q Care Plus | $0 (99% of insured) | Select states | Yes | Not yet |
| Freddie | $0 for most | 50 states | Yes | Coming soon |
| Nurx | $15–$30 consult + lab fees | ~36 states | Yes | No |
| PlushCare | $99–$129 consult + membership | Most states | No | No |
For a detailed breakdown of each platform, see our full telehealth comparison.
Not sure which option is right for you?
Our eligibility tool cross-references your insurance, state, income, and preferences to show you exactly which programs you qualify for.
Find My Free PrEP PathAll Programs at a Glance
| Program | Who It's For | What It Covers | Status |
|---|---|---|---|
| ACA Preventive Coverage | Privately insured | Medication + labs + visits at $0 | Active — upheld by SCOTUS June 2025 |
| Gilead MAP | Uninsured, ≤500% FPL | Free Descovy or Yeztugo | Active |
| Gilead Copay Savings | Commercially insured | Up to $7,200–$8,000/year | Active |
| ViiVConnect PAP | Uninsured, ≤500% FPL | Free Apretude | Active |
| ViiV Copay Savings | Commercially insured | $0 copay for Apretude | Active |
| Patient Advocate Foundation | Insured, ≤400% FPL | Up to $7,500/year copay | Active — merging into TotalAssist July 1 |
| Good Days Foundation | Medicare/military, ≤500% FPL | Up to $7,500/year copay | Check status |
| State PrEP DAPs | Varies (12 states) | Varies by state | Active |
| Ready, Set, PrEP | — | — | Ended July 2025 |
| Gilead Truvada PAP | — | — | Ended Jan 2025 |
Frequently Asked Questions
Is PrEP really free?
For most Americans, yes. If you have private insurance, the ACA requires $0 cost-sharing for PrEP — a requirement the Supreme Court upheld in June 2025. If you're uninsured and earn under ~$79,800/year, manufacturer programs provide free brand-name medication, and telehealth platforms like MISTR cover labs and visits at no cost.
Can I get PrEP without seeing a doctor in person?
Yes. Telehealth platforms provide the full PrEP experience remotely — video consultation, at-home lab kits, prescription, and medication delivery. You never need to visit a clinic unless you prefer to or need injectable PrEP administered.
Can undocumented immigrants get PrEP?
Yes. Gilead's Medication Assistance Program does not require a Social Security Number and explicitly serves undocumented residents. FQHCs serve patients regardless of immigration status. Telehealth platforms like MISTR also serve undocumented individuals.
What happened to Ready, Set, PrEP?
The federal Ready, Set, PrEP program stopped accepting new enrollments on July 30, 2024 and fully ended on July 18, 2025. No replacement federal program has been established. Read our full explainer on what replaced it.
Can I get generic PrEP for free?
This is currently the biggest gap. With Gilead's Truvada PAP gone, there is no manufacturer program for free generic TDF/FTC. Your options are: the 12 state PrEP DAPs (some cover generics), 340B-based telehealth platforms, or FQHCs with sliding-fee scales. Alternatively, Gilead's MAP provides free brand-name Descovy, which works just as well.
Is the $0 PrEP coverage requirement still safe after Braidwood?
Yes — for now. The Supreme Court ruled 6–3 in Kennedy v. Braidwood Management (June 27, 2025) that the ACA's preventive services mandate is constitutional, preserving the $0 PrEP requirement. However, religious exemption claims (RFRA) remain unresolved on remand, meaning some religious employers may eventually be able to opt out of PrEP coverage. For the vast majority of insured Americans, $0 PrEP is settled law.
Does PrEP have side effects?
Most people tolerate PrEP well. Common early side effects include mild nausea, headache, and fatigue — these typically resolve within the first few weeks. Long-term, TDF-based PrEP (Truvada/generic) carries a small risk of kidney and bone density effects, which is why quarterly lab monitoring is part of PrEP care. Descovy (TAF-based) has a better kidney and bone safety profile. Read our side effects guide for detailed information.
Is Yeztugo covered by insurance?
As of early 2026, more than 85% of US insurers cover Yeztugo, including all three major pharmacy benefit managers. However, because the USPSTF's 2023 PrEP recommendation predated Yeztugo's approval, the ACA's $0 cost-sharing requirement may not automatically apply to Yeztugo specifically. If your plan charges a copay, Gilead's copay savings program covers up to $8,000/year. If you're uninsured and under 500% FPL, Yeztugo is free through Gilead's MAP.