Biden Administration Calls for Medicare to Cover HIV Drug, PrEP

The Biden administration is recommending that Medicare cover the oral and injectable HIV-fighting medications known as pre-exposure prophylaxis, or “PrEP,” at no cost for persons at high risk for HIV infection.

“The determination of whether an individual is at high risk for HIV infection is made by the physician or health care practitioner who assesses the individual’s history,” said the National Coverage Determination from the Centers for Medicare and Medicaid Services.

“Currently, Medicare beneficiaries are only guaranteed access to daily oral PrEP through Part D and face out-of-pocket costs, and long-acting injectable PrEP has not generally been covered,” said a ...