Truvada Medicare Coverage

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.

How much does Emtricitabine/Tenofovir cost with Medicare?

Emtricitabine/Tenofovir coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Emtricitabine/Tenofovir?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Emtricitabine/Tenofovir, the generic form of Truvada, in 2023.¹

• Medicare Advantage plans or Part D plans that cover Emtricitabine/Tenofovir include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2024 Medicare Advantage plans include prescription drug coverage.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 Emtricitabine/Tenofovir. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

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.

Written by Hayden Gharibyar, Pharm.D.