Contact info
- Phone
- 1-800-226-2056
- Fax
- 1-800-216-6857
Eligibility
- The patient must be uninsured or underinsured.
- Patients with Medicare Part D should contact the program for details.
- This program also provides reimbursement support and co-pay assistance.
- Income limit, single
- 500% of the federal poverty level
- Income limit, couple
- 500% of the federal poverty level
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Yes
- US citizenship or residency required
- Yes
Not sure where your income falls? See this year's federal poverty guidelines (opens in a new tab).
Application process
- Documents to attach
- Proof of income
- Prescription needed for Vistide only
- Prescriber license number
- NPI number
- State license number
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Provider and patient
Getting the medication
- Patient receives
- Varies
- Shipped to
- Provider or patient
- Supply per shipment
- Not published
- Time to first delivery
- 0–2 weeks
- Refills
- Not published
- Staying enrolled
- New application every 12 months
- New proof of income every 12 months
Medications covered
- Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide)
- Bixlenvo (bictegravir and lenacapavir tablet)
- Descovy (emtricitabine/tenofovir alafenamide)
- Genvoya (elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide)
- Odefsey (emtricitabine/rilpivirine/tenofovir alafenamide)
- Stribild tablet (elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate)
- Sunlenca (lenacapavir)
- Yeztugo (lenacapavir)