Financing HIV PrEP - Webinar 2/23/22 - Financing & Coverage Strategies

Sep 27, 2026

Financing HIV PrEP webinar equips attendees with practical knowledge on how insurance coverage changes affect patient access and how to implement third-party insurance billing. It explains what 340B is and how it supports the PrEP financing landscape, then maps additional funding streams and assistance programs. The agenda addresses insurance billing, Medi-Cal/Medicare/third-party insurers, 340B opportunities, and combining funding sources while supporting PrEP navigation and medication adherence for insured, uninsured, and underinsured individuals.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages72

Reading Time3 h 1 min

AccessFree to download

Objectives

Agenda

Disclosures

Polling Question

Contents

Insured Individuals

Uninsured/Underinsured

Assistance Programs - Navigation/Linkages

Providing Access to PrEP in Public Health Settings

Patchwork of Funding and Delivery

Financing HIV PrEP Denise Smith, BSN, MPA, CBA Specialist San Francisco Department of Public Health Patrick G. Salazar, HIV/STD Program Coordinator Disease Control | Health Services Division Kern County Public Health Services Department HIV Capacity Building Assistance (CBA) Program-getSFcba Jesus Gaeta, MPH CBA Coordinator Fredah Rajab CLI Coordinator Dallas Baker Jr. CBA Program Assistant [Visit:](Visit: www.getSFcba.org)[ www.get](Visit: www.getSFcba.org)[SF](Visit: www.getSFcba.org)[cba.org](Visit: www.getSFcba.org) [Email:](Email: get.SFcba@sfdph.org)[ get.](Email: get.SFcba@sfdph.org)[SF](Email: get.SFcba@sfdph.org)[cba@sfdph.org](Email: get.SFcba@sfdph.org) Indigenous Land Acknowledgment We acknowledge that we are on the unceded ancestral homeland of the Ramaytush (Rah-my-toosh) Ohlone (O-lon-ee) who are the original inhabitants of the San Francisco Peninsula. As the Indigenous stewards of this land, and in accordance with their traditions, the Ramaytush Ohlone have never ceded, lost, nor forgotten their responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory. As guests, we recognize that we benefit from living and working on their traditional homeland. We wish to pay our respects by acknowledging the Ancestors, Elders, and Relatives of the Ramaytush Ohlone community and by affirming their sovereign rights as First Peoples. Objectives By the completion of this webinar, attendees will be able to: • Describe changes in coverage by insurance companies. • Steps to implement 3 rd party insurance billing. • Summarize what 340B is and how it fits into the financing landscape. • List other funding streams and assistance programs which can assist patients to successfully get on PrEP. Agenda • Insurance Billing and Coverage Changes • Medi-Caid (Medi-Cal), Medicare, 3 rd party Insurances • 340B Opportunities in Providing PrEP • Blending Funding Streams and Assistance Programs • Assisting patients with PrEP navigation and medication adherence. Disclosures No Disclosures Polling Question Where do you work? • Health Department • Community Based Organization (CBO) • Federally Qualified Health Center (FQHC) • Other Contents Insured Individuals Uninsured/Underinsured Assistance Programs Navigation/Linkages Providing Access to PrEP in Public Health Settings • The Centers for Disease Control and Prevention (CDC) recommends pre-exposure prophylaxis (PrEP) as an HIV prevention strategy and is an essential component of PS18-1802 funding. • Cost of PrEP approximately $12,000/yr. (Blaylock, 2018, MMWR) • Cost of ancillary services can be between $924 to $2143/yr.(Smith, 2017, JAIDS) • Financing for medication and medical follow-up can be very complex especially for non-insured or under-insured. Patchwork of Funding and Delivery | | Drugs | Clinical Visits and labs | Linkages / Navigation | | --- | --- | --- | --- | | Insured | Payer coverage; copay assistance through
assistance programs | Payer coverage with copays; some State Assistance Programs for copays | Adherence counseling which includes patient education, reminder systems for taking meds and developing plan for adverse effects | | Uninsured | Patient Assistance programs (manufacturer, state funded); clinics using 340B savings | State Funded assistance programs; Community Health Centers, Family Planning Clinics, STD clinics using 340B savings or other Federal, State or local funding. | State Funded assistance programs; CDC Prevention grants; Community Health Centers; Family Planning Clinics; STD clinics using 340B savings; or other Federal, State or local funding. |

FAQs

What will attendees be able to do after completing the webinar?

Describe insurance coverage changes, implement third-party insurance billing steps, summarize 340B and its role, and identify other funding streams and assistance programs that help patients start PrEP successfully.

What topics are covered in the agenda?

The agenda includes insurance billing and coverage changes, Medi-Cal/Medicare/third-party insurances, 340B opportunities, blending funding streams and assistance programs, and supporting PrEP navigation and medication adherence.

How does funding and delivery differ for insured versus uninsured/underinsured individuals?

For insured people, payer coverage and copay assistance through programs support drugs and visits, with adherence counseling and education. For uninsured/underinsured individuals, patient assistance programs and 340B savings are used, supported by state and community-funded assistance and navigation through state programs, CDC prevention grants, and health centers.

Sep 27, 2026

Uploaded by Guten tag