You may already have coverage for PrEP through work benefits, a family member’s coverage or private insurance you pay for yourself.

If you have private drug coverage your plan likely covers at some or all of the cost of PrEP. How much you pay and how much your insurance covers depends on your specific plan.

To find out if your plan covers PrEP and how much it will cost, talk to a pharmacist. The pharmacist will need to see your insurance card and the drug identification number (DIN) to see if your plan covers PrEP.

Here are the drug identification number (DINs) for different brands of PrEP:

• Teva-Emtricitabine/Tenofovir: 02399059
• APO-Emtricitabine/Tenofovir: 02452006
• Mylan-Emtricitabine/Tenofovir: 02443902
• Truvada (name-brand): 02274906
• Descovy (tenofovir alafenamide/emtricitabine) DIN: 02454424

If your out-of-pocket (te amount that you have to pay yourself) is still too high, you can use the Trillium Drug Plan to help cover the costs.

If you don’t have an insurance plan for medications, you can consider buying a private plan (e.g. Blue Cross, Green Shield) before starting PrEP. If you do not have any pre-existing health conditions, a private plan can be an affordable way to get PrEP. Your health care provider may be able to refer you to someone who can help find the best coverage for your needs.

The Trillium Drug Program helps people with high medication costs pay for PrEP.

If you don’t have a drug plan or your plan doesn’t cover the full cost of your PrEP, you may be eligible for the Trillium Drug Program if you:

• Live in Ontario
• Have a valid Ontario health card number
• Do not qualify for the Ontario Drug Benefit Program (through programs like Ontario Works)
• Spend about 3-4% of your after-tax household income on prescription drugs
  • Your household income is based on the amount of income you earn plus the income of a partner or any other family member who you support or who supports you financially.

Visitors to Canada can import prescription medications for ongoing treatment directly to their home address in Canada. Online pharmacies are able to get PrEP medications from countries outside Canada for as little as $30 a month. When you are importing medications to Canada, you have to give documents to Canadian Border Services that prove you are a visitor to Canada. Follow this link for more detailed information about how to import medication.

The Ontario Drug Benefit covers the cost of PrEP for Ontarians enrolled in a variety of support programs. 

If you are enrolled in Ontario Works, the Ontario Disability Support Program, or home care or community care, then you have coverage for a variety of medications, including PrEP, through the Ontario Drug Benefit program. 

• When you fill a prescription, show your OHIP card to the pharmacist and you will only have to pay up to $2 each time you fill a prescription. 

Follow this link to learn more about the Ontario Drug Benefit. 

OHIP+ covers the cost of PrEP for Ontarians 24 years old and younger with a valid OHIP card and no private drug coverage.

If you are 24 years old or younger, have a valid OHIP health card, and do not have private drug coverage, you are automatically covered by OHIP+. Show your OHIP card to the pharmacist and you will only have to pay up to $2 each time you fill your prescription.

Ontarians age 65 and older who have a valid OHIP card are covered for PrEP.

If you are 65 years old or over and have a valid OHIP card, you are covered by Seniors Coverage.

This program provides different levels of coverage based on your household income:

• If you are single and earn $25,000 or you are part of a couple with a combined yearly income under $41,500, you will pay up to $2 each time your fill your prescription.
• If you are single and earn $25,000 or more or you are part of a couple with a combined yearly income of more than $41,500, you will pay the first $100 of all your prescription costs per person each year and then up to $6.11 for each prescription filled or refilled.

Follow this link to learn more about the Ontario Drug Benefit. 

People using the Interim Federal Health Program in Ontario are covered for PrEP.

The Interim Federal Health Program (IFHP) offers temporary health coverage to people who can’t get provincial or territorial health insurance, including resettle refugees and refugee claimants.

If you are enrolled in IFHP you have coverage for a variety of medications, including PrEP. IFHP only covers your medication costs if you do not have coverage through another government drug program or through private insurance.

When you are filling a prescription, show your IFHP coverage document to your pharmacist.

Follow this link to learn more about the Interim Federal Health Program (IFH). 

First Nations and Inuit people eligible for the Non-Insured Health Benefits programs are covered for PrEP. 

The Non-Insured Health Benefits program is only open to Indigenous people with specific legal status in Canada, including First Nations people registered as an Indian under the Indian Act or Inuks who are recognized by an Inuit Land Claim organization. NIHB covers the cost of PrEP, although it only covers your medication costs if you do not have drug coverage through another government program or through private insurance.

If you think you might be eligible or want more information to see if you can apply, contact the Ontario regional NIHB office at 1-800-640-0642.

Follow this link to learn more about the Interim Federal Health Program (IFH). 

Canadian Armed Forces personnel are covered for PrEP through Canadian Forces Health Care.

If you are a member of the Armed Forces, you can access PrEP through your military health coverage. If health care providers at your base, wing or unit are not willing to prescribe PrEP, you can use your Canadian Forces Health Care Identification card (also called a Blue Cross Card) at off-base clinics to access PrEP and at community pharmacies to pay for it and other prescriptions.

If you do not have a Canadian Forces Health Care Identification card, call 1-866-886-1304 to ask about acquiring one. You do not have to say you plan to use your card to access PrEP.

Follow this link to learn more about the Interim Federal Health Program (IFH). 

Veterans Affairs Canada (VAC) treatment benefits cover the cost of PrEP. 

Veterans enrolled in Veterans Affairs Canada (VAC) health programs (including Long-Term Care, Disability Benefits, the Veterans Independence Program, or the War Veterans Allowance) can get PrEP for free through VAC’s Treatment Benefits program.

When you visit a pharmacy to get your medication, bring your VAC card. The pharmacist will bill the cost of your medication and any dispensing fees directly to VAC.

Follow this link to learn more about the Interim Federal Health Program (IFH).