Skip Navigation LinksOA_ADAP_Management_Memo_2022-11_PrEP-AP_Eligibility_Requirement_Change_to_PrEP_Patient_AP_for_Uninsured_Clients

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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


ADAP MM 2022-11
August 15, 2022


TO:
PrEP-AP Enrollment Workers

SUBJECT:
PrEP-AP Eligibility Requirement Change to PrEP Patient Assistance Program for Uninsured Clients

​ADAP Management Memo 2022-11:  PrEP-AP Eligibility Requirement Change to PrEP Patient Assistance Program for Uninsured Clients 


Addition of Ready, Set, PrEP for Unisured Clients

The purpose of this memo is to allow for the addition of "Ready, Set, PrEP" as an option for PrEP-AP uninsured clients required to enroll into a Patient Assistance Program (PAP).

Updated PrEP-AP Policy for Insured clients

Uninsured PrEP-AP clients were previously required to enroll into Gilead's Advancing Access® Patient Assistance Program to receive medication assistance with Truvada® and Descovy®. Uninsured clients can now enroll into either: "Ready, Set, PrEP" or Gilead Advancing Access® patient assistance program, to cover the cost of medication. PrEP-AP will be removing the requirement to upload proof of patient assistance program enrollment into the ADAP Enrollment System (AES). Although, PrEP-AP will remove the requirement to upload proof of a patient assistance program enrollment, clients must enroll into a patient assistance program, if eligibile.

Pharmacy Access for PrEP Medications

Enrollment in a patient assistance program is a requirement for uninsured PrEP-AP clients, and uninsured clients who do not enroll into a patient assistance program will not be able to access PrEP medications at a MagellanRx pharmacy. PrEP-AP clients enrolled in Ready, Set, PrEP or Gilead Advancing Access® must access their PrEP medications at a pharmacy associated with their pharmaceutical assistance program. All other medications on the PrEP-AP Formulary (PDF) must be accessed at a MagellanRx pharmacy.

Federal Ready, Set, PrEP program: 855-447-8410

  • Covers cost of Truvada® or Descovy®
  • No income limits
  • Must not have prescription drug coverage
  • Resident of the U.S. or its territories; social security Number (SSN) not required
  • Have taken an HIV test and received a negative result before enrolling in the program
  • Have a prescription for PrEP
  • Live in the United States, including tribal lands or territories
  • Ready, Set, PrEP is not used as a determination for public charge (PDF)

PrEP-AP clients enrolled in Ready, Set, PrEP must access their PrEP prescriptions at a Ready, Set, PrEP pharmacy.

Gilead Advancing Access® Patient Assistance Program: 800-226-2056 

Gilead Advancing Access® Patient Assistance Program Form (PDF)

  • Covers cost of Truvada or Descovy
  • Income at or below 500% FPL but above 138% FPL (Medi-Cal eligible)
  • Resident of the U.S. or its territories; SSN not required; undocumented residents eligible
  • Must be uninsured or insurance denies coverage, or have Medicare with no Part D benefits

PrEP-AP clients enrolled in Gilead Advancing Access® must access their PrEP prescriptions at an AssistRx pharmacy.

If you have any questions regarding the changes, please contact, PrEP-AP at PrEP.support@cdph.ca.gov  1-800-421-7050.

 

Thank you,

 Sharisse Kemp E Signature

Sharisse Kemp, MSW

ADAP Branch Chief

California Department of Public Health

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