Jumping Through Hoops

Hey everyone, I hope your new year has started off well! I know mine has. (I mean aside from the frigid temperatures and the several inches of snow St. Louis is experiencing today). So far, aside from the hangover morning I blogged about earlier, I have experienced zero physical side effects while on PrEP. But I wanted to take this snow day and check in and also talk about my process getting my PrEP prescription.

I titled this post "Jumping Through Hoops" because that is what it felt like I was constantly doing in order to get my hands on the TRUVADA, but I also have some extenuating circumstances that made it a bit more of a challenge. To give you an idea of the time frame, I first spoke with my doctor about getting a PrEP prescription on November 22, 2013 and I finally received the meds on December 26th. Now several factors played a roll in how long it took, so I'll walk you through my experience step by step to explain. I'm sure most people have different, easier stories, but this might serve as a resource for some people who are in my same shoes.

When I spoke with the nurse about the reason for my visit at the beginning of my first appointment, I actually had to repeat that I wanted to talk to the doctor about getting put on PrEP. She later told me she had never heard the term used before and had to ask the doctor what that was. I'm sure this is not uncommon. Luckily I go to a doctor who is familiar with PrEP and who I feel comfortable talking to about such things. It definitely made this process much easier.

When I spoke to the doctor about the circumstances of my relationship and told her about why I felt PrEP was an appropriate course of action, she agreed that TRUVADA would be a good tool in preventing infection. I'll go into my reasons behind my decision in a later post, but I will cover them because I feel that is an important part of this journey as well. Now after we decided to go forward with the prescription the first thing I needed was an HIV test because before you can get a prescription for TRUVADA as PrEP your doctor has to provide a negative HIV test.

After this is where the process became more complicated. The biggest reason for all of the hoops is simple, insurance. As I mentioned in my first post, I am currently an unemployed theatre person, I have spent the past two and a half years as a full-time student. Health insurance has been a very minimal expense for me. I have it, but just bare-bones emergency coverage, (one of those plans that is being dropped because of the Affordable Care Act), until I get a job, or win the lottery, or I am forced to change policies, my insurance does not include prescription coverage. TRUVADA is NOT a cheap prescription, however most plans will cover it. If you do not have prescription coverage there is another option. Gilead provides assistance for PrEP. This was the route I took. After discussing with the pharmacist my options, my doctor directed me to the website start.truvada.com. She said there was an agreement form I needed to print out and have us each sign. After some hunting I found http://start.truvada.com/hcp/truvadaprep-resources which had many different forms including the agreement form. I printed it out signed it and delivered it to my doctor.

I assumed this would be the end of it, I could give that signed form and the prescription to the pharmacy and get the meds. WRONG, I then found out I had to call Gilead. 1-855-330-5479 is the number for the Medication Assistance Program. They ask for information about your health Insurance and your income to determine whether you qualify for assistance. They also require a form to be filed out by both you and your physician. That form can be found at http://start.truvada.com/Content/pdf/Medication_Assistance_Program.pdf. So I filled out that form and got it to my doctor, who filled out their part and faxed the form to Gilead. I waited about a week for the confirmation that I qualified for the program for the next six months. Gilead then placed the order for my prescription with a pharmacy that would ship my medication directly to my doctor's office.

Now for most of you who have prescription coverage on you health insurance, most of these hoops won't be necessary. But if you do not have coverage, there are still options. I hope this was helpful information for some of you. Please let me know if you have any questions or comments about this or anything you would like me to cover in this blog. I love hearing from you all. Have a great day.

[Editor's note: This blog was originally written on Sunday, Jan. 4, 2014, Phil Gill's 11th day taking PrEP for HIV prevention.]

Read Phil's blog, Let's Talk About PrEP.