Truvada® Medicare Coverage

Truvada®
Chemical name: Emtricitabine/Tenofovir Disoproxil Fumarate

Typical dosage: 200mg/300mg

Typical type: Tablet1

Truvada® is a medication typically used to treat HIV infection and prevent HIV infection in HIV-negative patients to lower the chance of getting HIV infection through sex. Truvada is brand name only and is available as an oral tablet.

Truvada is not a cure for HIV and cannot fully prevent the risk of spreading HIV infection.

Truvada is a prescription medication that contains the active ingredients Emtricitabine and Tenofovir Disoproxil Fumarate. Patients on Truvada typically take one tablet once daily.

Truvada works by inhibiting HIV from replicating, which helps to lower the amount of HIV in the blood.

The major side effects of Truvada include headache, weight loss, belly pain, nausea, diarrhea and feeling tired or weak.

Does Medicare cover Truvada?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Truvada.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Truvada.

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Average costs for Truvada with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$42 – $1,827 $42 – $1,827

Additional information

Truvada is not a cure for HIV. Truvada can lower the risk, but not fully prevent spreading HIV to others. Truvada should be used in combination with safe sex practices to prevent HIV infection in high-risk persons.

Truvada has a Risk Evaluation and Mitigation Strategies (REMS) program that incorporates education for safe use and safe sex practices.  

If you are HIV negative, you must have a negative HIV test before taking Truvada and at least every 3 months while you take it. Tell your doctor if you think you have been exposed to HIV.

Bone problems like bone pain, soft bones and thin bones have happened with this drug. This may lead to broken bones. Talk to your doctor and take calcium and vitamin D as advised.

Truvada can cause hepatitis B to get worse when the medication is stopped in some patients. Close follow-up may be required by your doctor if you have hepatitis B.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 GoodRx. Truvada. Retrieved May 2019, from www.goodrx.com/truvada.

2 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.