Why did Freddie introduce financial assistance programs?
While PrEP is free for many people in Canada through provincial coverage, the unfortunate reality is that it is not free for everyone. Here is who is covered provincially in the five provinces Freddie currently serves:
Freddie’s new financial assistance programs were introduced to help our patients better afford PrEP. These programs are completely unique in Canada.
Financial assistance by Canadian provinces
Alberta & Saskatchewan
PrEP is fully covered provincially for people in Alberta and Saskatchewan who clinically qualify, so you can get completely free PrEP with your health card! Some pharmacies still charge co-pays and dispensing fees, but with Freddie you can get PrEP delivered 100% for free.
PrEP is fully covered provincially for people who are 24 years old and younger under the OHIP+ program. So you can get completely free PrEP with your OHIP card!
Unfortunately, PrEP is not covered for those who are 25 years old and older, so Freddie has introduced two financial assistance programs for these individuals:
Program 1: (Almost) everyone with insurance pays a $0 co-pay with Freddie
While the majority of private insurance plans cover PrEP, they usually do not cover the full cost and the patient must pay a “co-pay.” PrEP costs around $250/month in Ontario and most insurance plans cover 80% of the cost, although this varies from 50% to 100%. Thus, insurance typically covers around $200/month and the patient typically pays about $50/month.
We know from experience that this cost is a barrier to people accessing PrEP. And it shouldn’t be.
At Freddie, we provide financial assistance of up to $100/month. So if your co-pay is $50, you pay $0. And if your co-pay is $120, you pay $20. This means the vast majority of patients with insurance pay a $0 co-pay with Freddie. And more people who need PrEP can access it.
Program 2: Financial support for those without insurance
If you do not have not have private insurance, you can get the Trillium Drug Program. Trillium is a prescription drug coverage program run by the Ministry of Health that is open to all Ontarians who have OHIP. There is an annual deductible of 4% of household after-tax income. However even with Trillium, PrEP can be expensive.
Freddie wants to make PrEP affordable to everyone, so we offer a financial assistance program that helps with your Trillium costs. Depending on your income, PrEP will either be free or low cost! Fill in our medical questionnaire and speak with our clinicians to find out more.
Three months of free PrEP while you wait for your coverage
Getting coverage for PrEP can take a few months. Freddie helps you get on PrEP right away. Whether you have moved to a new province and are waiting for your provincial coverage to kick in (which takes up to three months) or you just applied for Trillium and are waiting for your application to be approved, Freddie provides three months of free PrEP so you can be protected right away.
Under Quebec law, financial assistance programs to support the cost of medication for PrEP are unfortunately not allowed, regardless if someone has RAMQ or private insurance. On December 7, 2016, the Quebec government enacted Bill 92 which, among other things, introduced a ban against financial assistance to patients through a new Section 80.2(1). You can read a summary of this put together by the law firm Fasken here or the official government language here.
Regardless of your coverage situation, you can still book a consultation with a Freddie provider to discuss PrEP coverage options.
Program 1: Financial support for those who have private insurance
While the majority of private insurance plans cover PrEP, they usually do not cover the full cost and the patient must pay a “co-pay.” PrEP costs around $250/month in Nova Scotia and most insurance plans cover 80% of the cost, although this varies from 50% to 100%. Thus, insurance typically covers around $200/month and the patient typically pays about $50/month.
At Freddie, we provide financial assistance of up to $20/month. So if your co-pay is $50, you pay $30.
This lowers the cost of PrEP, so more people can access it.
Program 2: Financial support for those who have co-pays through Pharmacare (coming soon!)
While PrEP is covered provincially by Pharmacare in Nova Scotia, there unfortunately high deductibles and co-pays for anyone who earns more than $25,000 per year. You can calculate how much you would pay through this online calculator. Freddie is working on developing financial assistance programs for our Nova Scotia patients using Pharmacare.
Freddie’s mission is to make PrEP affordable and accessible for everyone. We hope you join us in this journey to empower people to enjoy sex and protect those we love from HIV.
If you would like to understand how much you will pay for PrEP or to get on PrEP, take the 1 minute eligibility assessment.