Truvada

Emtricitabine / Tenofovir

EMTRICITABINE; TENOFOVIR DISOPROXIL FUMARATE is 2 antiretroviral medicines in 1 tablet. It is used with other medicines to treat HIV. This medicine is not a cure for HIV. This medicine can lower, but not fully prevent, the risk of spreading HIV to others. This medicine can also be used with safe sex practices to prevent HIV infection in high-risk persons. Compare HIV NNRTIs.

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Truvada Medicare Coverage

Overview

Does Medicare cover Truvada?

Yes.

100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Truvada co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Deductible

Typical

Donut Hole

Post-Donut Hole

Co-Pay Range

$54 – $68

In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.

Co-Pay Range

$13 – $68

In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.

Co-Pay Range

$24 – $30

In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.

Co-Pay Range

In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.

Want an exact price for your co-pay?

Ways to Save on Truvada

Here are some ways that may lower the cost of your Truvada prescription.

Manufacturer Coupon

Co-pay assistance is available for insured and uninsured patients.

Learn More

Patient Assistance Program from Gilead

Call Gilead Advancing Access to get more information on how they can financially assist you.

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Patient Assistance Program from PAN Foundation

Call to get more information on how they can financially assist you with your prescription.

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Truvada Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Truvada that may include:

Quantity Limits

Most Medicare plans restrict the amount of this prescription that can be purchased at one time. If you need to purchase a greater amount at one time, it may not be covered. Your options are to wait until that time period has passed before refilling, call your plan and ask for an exception, or consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Truvada typically on?

Tier 5

Medicare plans typically list Truvada in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). They are accurate as-of April 2019 and the information may be updated. If you encounter any issues, please let us know.

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