September 16, 2021
Premera has updated its preventive care benefits for HIV pre-exposure prophylaxis (PrEP) drug coverage to ensure intervention includes essential support services. These changes are in response to new clarifying guidance from the federal government on
how we should implement the U.S. Preventive Services Task Force (USPSTF) recommendation for PrEP.
The new benefit changes are effective September 17, 2021, for all members with non-grandfathered health plans. When billed with PrEP coverage, the following items may be covered in full:
- HIV and STI testing
- Hepatitis B and C testing
- Creatinine testing and calculated estimated creatine clearance (eCrCl) or glomerular
- filtration rate (eGFR)
- Pregnancy testing
- Sexually transmitted infection (STI) screening and counseling
- Adherence counseling (discussion of medication reminders, side effects, social support, etc.)
For more information, view recent
medical
policy and coding updates. Resources will be updated as applicable.