All Medicare Part D (prescription drug) and Part C (Medicare Advantage) plans cover emtricitabine/tenofovir disoproxil fumarate (Truvada). A more affordable generic form has been available since 2021.
Truvada is the brand name of a prescription medication, emtricitabine/tenofovir disoproxil fumarate, used to treat and prevent HIV. It’s a type of medication known as antiretroviral drugs.
The amount you’ll pay for emtricitabine/tenofovir disoproxil fumarate (Truvada) depends on your plan, how the drug is classified within the plan’s tier system, and your eligibility for any programs that help could lower costs.
The patent for emtricitabine/tenofovir disoproxil fumarate (Truvada) expired in 2020, and several generic options were released in 2021. These generics significantly reduced the cost of this medication. Medicare covers generic emtricitabine/tenofovir disoproxil fumarate.
Let’s take a closer look at what different Medicare plans will cover if you’re prescribed emtricitabine/tenofovir (Truvada).
Medicare Part D plans are prescription drug plans, and they’re required to cover antiretrovirals like emtricitabine/tenofovir disoproxil fumarate (Truvada).
However, private insurance companies offer Part D plans, and each plan’s costs and coverage guidelines can differ.
Your costs will depend on several factors, including:
- whether you have met your prescription drug deductible for the year
- what your plan’s cost-sharing requirements are
- how your plan ranks emtricitabine/tenofovir disoproxil fumarate (Truvada) and the generic version on its tier system
- whether you’re eligible for any special programs that help with your costs
You can check your plan’s formulary, which is the list of prescription drugs your plan covers, to find out how your plan classifies emtricitabine/tenofovir disoproxil fumarate (Truvada) and the generic form.
If you’re considering a change to your Medicare Part D plan, you can use Medicare’s plan comparison tool to check the coverage for any medication you use.
What about Medicare Part C coverage?
Private insurance companies also offer Medicare Part C (Medicare Advantage) plans. These plans provide the same benefits as Original Medicare (Part A and Part B) but usually include other benefits, such as vision and dental care.
You can buy Medicare Advantage plans with or without prescription drug coverage. If the plan you choose doesn’t include prescription drug benefits, you can switch to a plan that does. You can make this change during one of the enrollment periods throughout the year.
If you’re using emtricitabine/tenofovir disoproxil fumarate (Truvada) to treat HIV, you may qualify for a Special Needs Plan. These are a type of Medicare Advantage plan that offers extra benefits to people with certain complex conditions, such as diabetes, heart disease, or HIV.
To find the cost of emtricitabine/tenofovir disoproxil fumarate (Truvada) with your Medicare Advantage plan, To find the cost of emtricitabine/tenofovir disoproxil fumarate (Truvada) with your Medicare Advantage plan, you’ll start by looking for the medication on your plan’s formulary. The formulary will tell you what tier emtricitabine/tenofovir disoproxil fumarate (Truvada) is in and will explain any limitations or guidelines that affect your prescription.
You’ll also need to know your plan’s prescription drug deductible, as the cost of the drug may change once you’ve met it.
Can a Medigap plan help with my costs?
Medigap plans, also known as Medicare supplement insurance, help you pay the coinsurance, deductibles, and copays for your healthcare. Like Medicare Part C and Part D plans, they’re offered by private insurance companies. So, specific benefits differ from plan to plan. Medigap plans are only available to people who have Original Medicare (parts A and B).
Some Medigap plans sold before 2006 included prescription drug coverage. Medigap plans sold after 2006, however, don’t include this coverage. This means the newer plans won’t cover your costs for emtricitabine/tenofovir disoproxil fumarate (Truvada).
Exactly how much you pay for emtricitabine/tenofovir disoproxil fumarate (Truvada) depends on your Medicare Advantage or Part D plan.
Gilead, the company that manufactures emtricitabine/tenofovir disoproxil fumarate (Truvada), has announced that it will make a generic version of the medication available in September 2020, a year ahead of schedule. Additionally, the company has promised to donate supplies of emtricitabine/tenofovir disoproxil fumarate (Truvada) for as many as 200,000 people for up to 11 years.
If you need assistance paying for this prescription drug, check the company’s website for more information on how to apply.
Truvada is a pill that contains a combination of two antiretroviral drugs: emtricitabine (Emtriva) and tenofovir disoproxil fumarate (Viread).
In 2021, several pharmaceutical companies began selling a generic emtricitabine/tenofovir disoproxil fumarate (Truvada) called emtricitabine-tenofovir (TDF).
How is it used to treat HIV?
Emtricitabine/tenofovir disoproxil fumarate (Truvada) isn’t a cure for HIV. It is used in combination with other antiretroviral medications to treat HIV-1 in adults and children 12 years old and older.
This combination of medications suppresses the presence of the virus in your body over time by blocking an enzyme that the virus uses to make copies of itself. Truvada can sharply decrease the amount of HIV in your body because the virus can’t replicate.
Once the amount of HIV in your blood drops below a certain level (200 units per mL), tests can no longer detect it. At that point, the virus is considered to be suppressed.
Research has shown that once the virus is undetectable, there’s almost zero risk of transmitting it to someone else through sex. Truvada may be prescribed as part of a treatment regimen for HIV. It is not enough to use it alone.
How is it used to prevent HIV transmission?
People who don’t have HIV can take emtricitabine/tenofovir disoproxil fumarate (Truvada) to reduce the risk of contracting HIV through sex or the use of injected drugs. Truvada can be used as part of a
When people who don’t have HIV take the medication daily, their risk of contracting HIV through sex is lowered by 99%, and the risk of contracting HIV through injection drug use drops by 74%.
Emtricitabine/tenofovir disoproxil fumarate (Truvada) works best when taken daily because the body needs enough medication to stop the virus.
Though emtricitabine/tenofovir disoproxil fumarate (Truvada) drastically reduces the presence of HIV in the body, the
What should I expect when taking Truvada?
You may have side effects while taking emtricitabine/tenofovir disoproxil fumarate (Truvada), some of which are mild and others are more serious.
Some of the most common side effects include:
- tiredness
- nausea
- vomiting
- diarrhea
- headaches
- rash
- depression
- anxiety
- stomach pain
- nasal congestion
- trouble sleeping
These symptoms often go away on their own after a while, but it’s a good idea to talk with your healthcare professional if you’re concerned about them. It’s also very important to talk with your doctor if you experience flu-like symptoms after taking emtricitabine/tenofovir disoproxil fumarate (Truvada) because they might indicate exposure to HIV.
The
Emtricitabine/tenofovir disoproxil fumarate (Truvada) can also cause serious side effects.
One is a buildup of lactic acid in your body, called lactic acidosis. Lactic acidosis can be life threatening. emtricitabine/tenofovir disoproxil fumarate (Truvada) may also cause serious liver problems.
If you experience any of the following symptoms after you take emtricitabine/tenofovir disoproxil fumarate (Truvada), talk with your healthcare professional right away:
- fatigue or weakness
- muscle pain
- shortness of breath
- stomach pain combined with nausea and vomiting
- cold or blue hands and feet
- dizziness
- fast heartbeat
- yellow skin or eyes
- dark urine
- pale bowel movements
- loss of appetite for longer than a few days
Emtricitabine/tenofovir disoproxil fumarate (Truvada) is a prescription drug used to treat and prevent HIV. All Medicare Advantage and Medicare Part D prescription plans cover Truvada, but deductibles, copays, and coinsurance vary from plan to plan.
To make sure a plan you’re considering has coverage options for emtricitabine/tenofovir disoproxil fumarate (Truvada), you can check the plan’s formulary (list of covered prescription drugs) or talk with your insurance provider.