PrEP is one of the most effective ways to prevent HIV, but many people assume it is expensive. In practice, most people with insurance can get PrEP at no cost, and there are still low-cost and free options for people without insurance. Here is what PrEP costs in the US and how to lower what you pay.

What is PrEP?

PrEP (pre-exposure prophylaxis) is prescription medication for people who do not have HIV, taken to lower the risk of getting HIV. It comes as daily pills or as long-acting injections given every two months or every six months. Taken as prescribed, PrEP is highly effective at preventing HIV from sex.

How much does PrEP cost without insurance?

Costs vary widely by option:

Generic daily pills: generic emtricitabine/tenofovir disoproxil fumarate is the lowest-cost option. With pharmacy discount programs, a month's supply can cost far less than the brand-name price.
Brand-name daily pills: newer brand-name tablets can cost well over $1,000 a month at list price.
Long-acting injections: list prices for injectable PrEP run to tens of thousands of dollars a year before insurance or assistance.

PrEP also involves HIV testing, lab work and regular check-ins, which add to the cost if you pay out of pocket.

Does insurance cover PrEP?

Yes, in most cases. Under the Affordable Care Act, most private health plans must cover PrEP as a recommended preventive service without copays, coinsurance or deductibles. That includes the required HIV tests and many related lab services. In June 2025 the US Supreme Court upheld this requirement.

Medicaid covers PrEP in every state, and Medicare Part D plans cover PrEP medications, with costs depending on the plan.

Watch out for these coverage issues

Billing codes: if a visit or lab test is not billed as PrEP-related preventive care, you may receive an unexpected bill. Ask the clinic to bill it as preventive PrEP care.
Prior authorization: some plans require approval before covering brand-name pills or injections.
Preferred products: a plan may cover a generic at no cost but require a step or appeal for a brand-name product.
Grandfathered and short-term plans: some older or non-ACA plans may not follow the no-cost rule.

How to get PrEP for free or at low cost without insurance

The federal Ready, Set, PrEP program, which provided free PrEP medication to uninsured people, ended in 2025. Other options remain:

Manufacturer assistance programs: drug makers run patient assistance programs that can provide brand-name PrEP pills or injections at no cost to eligible uninsured people, based on income.
State PrEP assistance programs: several states run programs that help pay for PrEP medication, visits or labs.
Community health centers: federally qualified health centers charge on a sliding scale based on income.
Sexual health and public health clinics: many local health departments offer PrEP visits and HIV testing at low or no cost.
Telehealth PrEP services: some online providers offer PrEP visits, home lab kits and medication delivery, often at no cost for insured patients and with options for uninsured patients.

Tips to keep your PrEP costs down

Ask whether a generic is right for you.
Call your insurer and ask how PrEP medication, visits and labs are covered.
Ask the clinic to bill visits and tests as preventive PrEP care.
If you get an unexpected bill, ask for it to be reviewed and appeal if needed.
If you lose insurance, contact a community health center or the manufacturer's assistance program quickly so you do not have a gap in protection.

The bottom line

For most insured people in the US, PrEP should cost nothing out of pocket. Without insurance, generic pills, assistance programs, state programs and community clinics can make PrEP affordable or free. Talk to a healthcare professional about which PrEP option is right for you.

This article is for general information only and is not medical or financial advice. Coverage rules and programs change, so confirm details with your insurer and provider.