Hey everyone hoping you can help us out. I am actually a mentor for for the mentorship program and my mentee of course asked me something I DONT KNOW! For folks who are on their parents insurance, do insurance EOBs show information about medications/visits/labs and if so how does one get around it? We are in Pennsylvania which might change the answer. Are there any handouts on this for providers when learning about PrEP? THANKS!
Not sure about other states but in MA we have something call the PATCH Act (= Protecting Access To Confidential Healthcare) which allows patient to call insurers and not have EOBs sent to the policy holder. Other options like using programs for meds or even paying out of pocket using goodRx for generic meds is an option but only solves the medication issue but does not address visit and lab charges. It's a tough problem and even though we have a program like this in MA it's actually very cumbersome to try to operationalize it.
Unfortunately, the only option we have found is having people purchase generic Truvada with a GoodRx discount card. We overcome other costs by having people get labs at designated public health sites (Iowa HHS offers lab monitoring for no cost to the person), and our pharmacist-managed PrEP clinic does not charge for visits.
Heidi Wood, pharmacist
Useful piece of information to keep in mind and to break down the barriers.