Updated Coverage Guidance Under the Affordable Care Act: Long-Acting PrEP

On October 21, 2024, the Departments of Health and Human Services, Labor, and the Treasury (the Departments) issued new guidance. The guidance clarifies that with the United States Preventive Services Task Force’s (USPSTF) 2023 update to its recommendation on the prevention of acquisition of HIVExit Disclaimer, most health coverage that people receive through their employer, or purchase either through a Health Insurance Marketplace®, or directly from an insurance company are required under the ACA to cover without cost-sharing specified formulations of PrEP, including long-acting injectable PrEP and two formulations of daily oral PrEP.

To review the new guidance related to PrEP, read CMS.gov’s FAQs (PDF, 321KB).

For related additional about PrEP coverage, read about Medicare Part B coverage of PrEP for HIV prevention.