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Roadblock removed in the fight against AIDS

More people may now be able to afford drugs that block HIV, the virus that causes AIDS.

According to Kaiser Health News, a new policy kicked in this year requiring most private health insurance plans to cover the full cost of PrEP treatments.

PrEP stands for pre-exposure prophylaxis. The category includes drugs like Truvada and Descovy.

Research shows PrEP treatments can reduce the chance of getting HIV from sex by 99%. They can cut the risk of infection from IV drug use by 74%.

They’ve been available since 2012. But many people who could be taking PrEP aren’t. That’s in part because of the high cost of the treatments.

A study published in the American Journal of Public Health put the average cost at $2,000 a month. While insurance covered some of that, people taking the drugs still had to pay as much as $1,000.

Now that’s changing. Many patients will no longer be responsible for cost sharing through deductibles or copayments. Deductibles and copayments are fees you pay for medical services. They are known as out-of-pocket payments.

The change comes because of a move by the U.S. Preventive Services Task Force – a team of independent medical experts in prevention and primary care.

The task force gave PrEP therapy an “A” rating in 2019.

Under the Affordable Care Act (ACA), preventive services with an “A” or “B” must be covered by most private insurers without making plan holders share costs. A private insurance plan is the type of plan an employer might offer or that an individual person can buy. They are not run by or paid for by any government or public group. 

The change does not apply to health plans in effect before March 2010, when the ACA became law.

The change doesn’t help people who don’t have private insurance. However, drug manufacturer Gilead offers an assistance program.

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