Does Medicare cover it? A to Z
Does Medicare cover HIV PrEP?
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Short answer
Covered: Part B
Yes, Medicare Part B covers pre-exposure prophylaxis (PrEP) for HIV prevention as a preventive service if you don't have HIV and your doctor or other health care provider determines you're at increased risk for HIV.
With Medicare Part B, you pay nothing out of pocket for PrEP medication you get from a pharmacy enrolled in Part B, and nothing for injectable PrEP, HIV and hepatitis B screenings and counseling if your provider accepts assignment.
Medicare Part B PrEP coverage includes FDA-approved oral or injectable PrEP medication, up to 8 counseling sessions and up to 8 HIV screenings every 12 months, and a one-time hepatitis B screening.
| Fact | Figure | Source |
|---|---|---|
| Who's eligible | People without HIV whose provider determines they're at increased risk | Medicare.gov |
| PrEP medication | FDA-approved oral or injectable PrEP, plus the fee for giving an injection | Medicare.gov |
| Counseling | Up to 8 individual sessions every 12 months | Medicare.gov |
| HIV screenings | Up to 8 every 12 months | Medicare.gov |
| Hepatitis B screening | One time (you may be able to get more if you're at high risk or pregnant) | Medicare.gov |
| What you pay | Nothing at a Part B-enrolled pharmacy, and nothing for services if your provider accepts assignment | Medicare.gov |
What does Medicare cover for HIV PrEP?
PrEP uses antiretroviral medication to lower your risk of getting HIV (human immunodeficiency virus). Medicare Part B covers PrEP medication and related services. If you qualify, covered services include:
- FDA-approved oral or injectable PrEP medication. If you get an injectable drug, Part B also covers the fee for injecting it.
- Up to 8 individual counseling sessions, including HIV risk assessment, HIV risk reduction and medication adherence.
- Up to 8 HIV screenings.
- A hepatitis B virus (HBV) screening.
Who qualifies for Medicare PrEP coverage?
You qualify if you don't have HIV, but your doctor or other health care provider determines you're at an increased risk for HIV. PrEP is listed among the preventive services Medicare Part B covers.
What do I pay for PrEP with Medicare?
If you get PrEP medication from a pharmacy that's enrolled in Part B, you pay nothing out of pocket for your medication. Ask your provider to include a diagnosis code on your prescription to help the pharmacy. If your provider accepts assignment, you also pay nothing for injectable PrEP drugs, HIV and hepatitis B screenings, and counseling sessions, because they're preventive services.
Contact your pharmacy to make sure it can bill Medicare Part B. If it can't, you might have to pay the full cost of PrEP yourself. Most pharmacies, including national chains, can bill Part B, but some smaller pharmacies can't. If your regular pharmacy can't, Medicare can help you find one at 1-800-MEDICARE.
How often does Medicare cover PrEP counseling and screenings?
If you qualify, you can get:
- Up to 8 counseling sessions every 12 months.
- Up to 8 HIV screenings every 12 months.
- A one-time hepatitis B screening. You may be able to get more screenings if you're at high risk for hepatitis B or you're pregnant.
Does Medicare Advantage cover PrEP?
Yes. If you're in a Medicare Advantage plan, you'll usually pay nothing out of pocket for PrEP at any pharmacy in your plan's network. Contact your plan for specific cost information. See how Medicare Advantage differs from Original Medicare.
Does Medicare cover HIV treatment drugs?
PrEP coverage under Part B is for preventing HIV. If you have HIV and take medication for treatment instead of prevention, your treatment is covered if you have Medicare drug coverage (Part D). Every Medicare drug plan must cover most drugs in certain protected classes, including drugs to treat HIV/AIDS. See how Medicare drug coverage works.
Good to know
More questions people ask
Is PrEP covered under Part B or Part D?
Does Medicare cover injectable PrEP?
Why would I pay for PrEP at the pharmacy?
How often does Medicare cover an HIV test without PrEP?
Related questions
- Medicare.gov: Pre-exposure prophylaxis (PrEP) for HIV prevention
- Medicare.gov: HIV screenings
- Medicare.gov: Hepatitis B virus infection screenings
- Medicare.gov: Preventive and screening services
- Medicare.gov: What do drug plans cover?
- Medicare.gov: Medicare & You handbook
Figures are Medicare’s, set nationally, and were checked against these pages on October 2026. For your own situation, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).
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This page was last updated: October 2026.