Windy City Media Group Frontpage News


home search facebook twitter join
Gay News Sponsor Windy City Times 2023-02-22



Feds expand insurers' requirements for PrEP coverage
by Matt Simonette

This article shared 2114 times since Thu Aug 26, 2021
facebook twitter pin it google +1 reddit email

Insurers and service-providers have until September to comply with a new federal guidance requiring insurance companies to cover the entire cost of PrEP (pre-exposure prophylaxis) interventions.

Many insurers have been covering the cost of PrEP medication, widely available as the pills Truvada or Descovy, for several years. Truvada became available in a generic formulation in 2020, and U.S. insurers have been prevented from charging co-pays for PrEP since the beginning of 2021.

But one aspect of PrEP has remained daunting for some community members unable to access comprehensive coverage through insurance or assistance programs: Paying for additional lab work or even follow-up medical visitations that a PrEP prescription requires. Those requirements could be "bracing" for some patients, according to activist Jim Pickett, who is at AIDS Foundation of Chicago (AFC).

"If you have insurance, that insurance must cover PrEP in full, and 'PrEP on full' means not just the prescription," said Pickett. "It means the office visits, the lab tests, any kind of counseling—all those things need to be covered completely. So that's a huge win."

PrEP was given a "Grade A" rating by the U.S. Preventive Services Task Force, an independent panel that issues recommendations about clinical preventative services. Under Affordable Care Act guidelines, that rating means insurers have to pay for PrEP services in full. The federal government issued the guidance July 19, and Illinois issued a follow-up about the state's implementation of the rule July 29.

"People often seemed to have everything covered, and then might get a lab bill," Pickett said. "Every insurance plan has different ways that they provide services or refuse services. There's not a lot of plans that up front will say that they will [pay for] a set of labs for you every three months. So people might get a [first] set of labs and it's okay, and then six months in, they get hit with hundreds of dollars in a lab bill."

Care providers generally recommend bloodwork, mainly to monitor kidney functions, every three months for persons using PrEP.

Pickett added, "There are a lot of programs in Chicago that try find support [to avoid financial surprises] so people can still move forward and aren't left hanging, but anything that any kind of friction like that comes up in the system, it's a huge deterrent. Getting an $800 bill is obviously a real deterrent."

PrEP adoption has increased in recent years. PrEP has been a central focus in the state's Getting to Zero initiative, which aims to reduce new HIV transmissions to "virtual zero" by the year 2030. Pickett said that it is too early to determine whether PrEP use has been on an upward- or downward-swing since the COVID-19 pandemic took hold. While some PrEP users might have not seen the point of continuing to use their medication when they were relatively isolated and having less sex, some providers eased access since so much of the work can be done via tele-health visits and with at-home testing.

"We're still in the middle of it all," Pickett added. "We've had waves [of COVID transmissions], but obviously this ain't over. … We'll have a better look at what goes on with COVID and PrEP as time goes on and we have more data. It's just the middle of 2021, and 2020 is when the whole shithouse came down. Oftentimes, we need a year out to see things better."

The PrEP landscape is likely to change even more in the months ahead. Researchers have been looking into administering the drug cabotegravir through injection as a PrEP intervention (as well as an injectable HIV treatment when combined with rilpivirine). Pickett has long spoken of a day when HIV-negative people might choose from a "menu" of PrEP options that best suited their particular situation: Persons who expect difficulty adhering to strict pill regimen might choose a long-lasting injectable option that only needs to be administered every few months, for example. Less sexually active people already can use a "PrEP on demand" protocal to guard against transmission when they anticipate an encounter.

Pickett added, "What I'm really interested in are mult-purpose technologies. Imagine an injection or an implant that also protects against other STI's. Also, this is coming soon: a dual pill that has contraception and HIV-prevention. You take one pill and you don't have to worry about unwanted pregnancy and you don't have to worry about HIV."

He added though, that advocates and providers shouldn't get overly excited about "the new shiny thing," since getting these medications and technologies to the people who need them is where systems tend to fall apart.

"Our health care system is confusing and is filled with friction," Pickett said. "It's filled with challenges. We make people jump through hoops and backflips with their insurance, assistance programs and pharmacy benefits. ... You can have the best technology in the world, but if you make it hard to get, and make people deal with paper, bureaucracy and waiting, guess what? It's not going to happen. We need a system focused on individuals."

This article shared 2114 times since Thu Aug 26, 2021
facebook twitter pin it google +1 reddit email


Gay News

NATIONAL Google Doodle, drag laureate, Nebraska bill, NYC AIDS Walk
D.C. poet/activist/journalist Ivy Young passed away at age 75, per a press release. Among other things, Young worked at Chicago's VISTA; the Center for Black Education and Drum and Spear Book Store in D.C.; the ...

Gay News

WORLD Japanese bill, 'HRC Equidad CL,' center closes, UN expert, amFAR gala
LGBTQ+-rights activists criticized a new bill submitted to the Diet (Japan's national legislature) aimed at "promoting understanding" of equality issues as a "meaningless gesture," Japan Today noted. Japan's coalition government ...

Gay News

Leading LGBTQ+ groups raise alarm to business community on coordinated anti-LGBTQ+ attacks; call on Target to lead
--From a press release - Organizations calling on Target and all businesses to stand up against anti-LGBTQ2S+ extremism in statement below: Family Equality, GLAAD, GLSEN, The Human Rights Campaign, National Center For Lesbian Rights, National LGBTQ Task Force, National Black J ...

Gay News

TaskForce Chicago's ED talks organization, AIDS stigma and queerness
Among the many organizations helping Chicago youths is TaskForce Prevention & Community Services. The West Side-based organization helps hundreds of youths by being committed to addressing the HIV/STI-related needs of ...

Gay News

SAVOR 'Round Table II' brings chefs, nonprofits together to discuss collective vision
On May 15, the Avondale restaurant eden, 2734 W. Roscoe St., was the site of a rather extraordinary gathering of Chicagoland chefs, nonprofit CEOs and other business leaders in a moving discussion that centered on building ...

Gay News

Lambda Legal marks 50 years with Bon Foster Civil Rights Celebration
Lambda Legal marked its 50th anniversary with The Bon Foster Civil Rights Celebration May 19 at the Art Institute of Chicago. The event honored Windy City Times Owner and Co-Founder Tracy Baim. The celebration was named ...

Gay News

HB 1286 would allow gender-inclusive multi-occupancy restrooms, Chicago groups respond
--From a press release - Statement from AIDS Foundation Chicago, Equality Illinois, and Pride Action Tank regarding HB 1286 to allow gender-inclusive multi-occupancy restrooms: We applaud the Illinois Senate for passing HB 1286 and urge the Illinois House to act expeditiously ...

Gay News

Modern Military Association of America appoints interim Executive Director
--From a press release - WASHINGTON, (May 17, 2023) — LGBTQ+ military nonprofit Modern Military Association of America (MMAA) announced today that nonprofit management expert Rachel Branaman, will step into the role of interim executive ...

Gay News

Belting for Life returns for an 8th edition
On May 15, Jeff Award-winning director and activist Christopher Pazdernik celebrated his birthday with the eighth edition of Belting for Life, his annual Chicago-style theatrical concert and fundraiser for AIDS ...

Gay News

Chicago House welcomes spring with 'Secret Garden' event
On May 7, Chicago House presented its annual spring fashion brunch, this year titled The Secret Garden, in the Winter Green Ballroom of the Harold Washington Library. The annual event, which some now regard as the ...

Gay News

Howard Brown responds to FDA's relaxation of blood-donation guidelines
Howard Brown Health has responded to The Food and Drug Administration (FDA)'s elimination of restrictions that had previously barred many blood donations by gay and bisexual men. The FDA said it will recommend a series of ...

Gay News

Howard Brown Health identifies Monkeypox (Mpox) resurgence
--From a press release - (Chicago, IL, May 5, 2023) — Howard Brown Health has identified a resurgence in cases of Monkeypox (Mpox) in the Chicago area. As of this morning, the agency has diagnosed seven new cases of mpox since ...

Gay News

LAMMY Awards announce host, presenters, special guests for June 9 event
--From a press release - New York, NY, May 4, 2023 — Lambda Literary, the nation's premier LGBTQ literary arts organization, announced updates and additions, including host, special guests and more at the upcoming 35th Annual Lambda Literary Awards — aka ...

Gay News

Rainbow Railroad seeks to resettle 50 LGBTQI+ people safely in the USA, including 20 in Chicago
Rainbow Railroad recently held an informational meeting at Center on Halsted to announce its partnership with U.S. State Department administered Welcome Corps sponsorship program. The organization has chosen the Chicago ...

Gay News

Chicago LGBT Hall of Fame nominations extended, participation in Chicago's LGBT Pride Parade announced
--From a press release - The Chicago LGBT Hall of Fame announced today, that it will once again be one of the leading floats in Chicago's LGBT Pride Parade on Sunday, June 25. McKinsey & Company will sponsor the Pride float. ...


Copyright © 2023 Windy City Media Group. All rights reserved.
Reprint by permission only. PDFs for back issues are downloadable from
our online archives. Single copies of back issues in print form are
available for $4 per issue, older than one month for $6 if available,
by check to the mailing address listed below.

Return postage must accompany all manuscripts, drawings, and
photographs submitted if they are to be returned, and no
responsibility may be assumed for unsolicited materials.
All rights to letters, art and photos sent to Nightspots
(Chicago GLBT Nightlife News) and Windy City Times (a Chicago
Gay and Lesbian News and Feature Publication) will be treated
as unconditionally assigned for publication purposes and as such,
subject to editing and comment. The opinions expressed by the
columnists, cartoonists, letter writers, and commentators are
their own and do not necessarily reflect the position of Nightspots
(Chicago GLBT Nightlife News) and Windy City Times (a Chicago Gay,
Lesbian, Bisexual and Transegender News and Feature Publication).

The appearance of a name, image or photo of a person or group in
Nightspots (Chicago GLBT Nightlife News) and Windy City Times
(a Chicago Gay, Lesbian, Bisexual and Transgender News and Feature
Publication) does not indicate the sexual orientation of such
individuals or groups. While we encourage readers to support the
advertisers who make this newspaper possible, Nightspots (Chicago
GLBT Nightlife News) and Windy City Times (a Chicago Gay, Lesbian
News and Feature Publication) cannot accept responsibility for
any advertising claims or promotions.






About WCMG      Contact Us      Online Front  Page      Windy City  Times      Nightspots
Identity      BLACKlines      En La Vida      Archives      Advanced Search     
Windy City Queercast      Queercast Archives     
Press  Releases      Join WCMG  Email List      Email Blast      Blogs     
Upcoming Events      Todays Events      Ongoing Events      Bar Guide      Community Groups      In Memoriam     
Privacy Policy     

Windy City Media Group publishes Windy City Times,
The Bi-Weekly Voice of the Gay, Lesbian, Bisexual and Trans Community.
5315 N. Clark St. #192, Chicago, IL 60640-2113 • PH (773) 871-7610 • FAX (773) 871-7609.