How much does PrEP cost in Ontario?

Will my insurance plan cover PrEP?

If you have health insurance through your work or school:

• Most insurance plans will cover oral and injectable PrEP, including workplace plans and university and college plans. Depending on your coverage, you may be required to pay a portion of the costs of your PrEP prescription. The Village Pharmacy gives you options to help lower your out-of-pocket costs through government and other patient support programs.

If you are on a government drug plan (eg. ODB, Trillium, OHIP+)

• At this time, government plans such as ODB, Trillium, OHIP+, ODSP, Ontario Works, Ontario Seniors Drug Benefit, NIHB, and others cover generic Truvada only.

Can I really get PrEP for free?

Free PrEP or very low cost PrEP is available! Here’s how you qualify:

• If you're 24 years old or younger and do not have insurance coverage through school, your parents plan, or your employer, prescription medications including generic PrEP, are free under the OHIP+ program. You'll need a valid Ontario health card number and a prescription. Read more about OHIP+ here.

• If you're over 25 years old and you don't have a health insurance plan, you can apply for the Trillium Drug Program. Although you’ll pay a deductible based on your income, your overall cost for PrEP will be significantly reduced.

• PrEP may also be free for some people in Ontario who are on the Ontario Disability Support Plan, Ontario Works, are over the age of 65, or have 100% coverage through a personal or employee health benefits plan.

Please note that government drug plans only cover Generic Truvada for PrEP.

I have drug benefits through my employer so how much will I pay out-of-pocket for PrEP?

Most drug benefits plans cover a major portion of the cost of prescription medications ranging from 50% to 100%, with most benefits plans in the 80% coverage range.

For example, if your plan offers 80% coverage, the insurer pays 80% of the cost and the you pay 20%.

If you have trouble paying the difference, especially if you are on brand name drugs such as Descovy or Apretude, The Village Pharmacy can enrol you in patient support programs to reduce your out-of -pocket cost for PrEP.

How much is my co-pay for PrEP?

If you have a 'Pay Direct' card provided to you by your drug benefits plan, email it to us at The Village Pharmacy and we'll tell you how much coverage you have, and what your out-of-pocket costs will be. 

You can confirm if PrEP is covered by your health benefits plan by contacting your Insurance provider directly. They may ask you for the Drug Identification Number (DIN) to check coverage.

See the common DINs for oral and injectable PrEP below.