The cost of PrEP varies depending on the province or territory you live in. In some provinces, the provincial government covers the cost of PrEP for eligible residents, and in others, the cost of PrEP may only be covered by provincial programs for some residents. Fortunately, Freddie offers financial assistance for PrEP with our Compassionate Care program and “bridging” program in order to increase Canada’s PrEP accessibility!
Without insurance, the cost of daily PrEP can be anywhere between $907 and $995.
As a Quebec resident, you legally need to have health coverage in place. The cost of PrEP differs based on whether you have public health coverage or private insurance.
If you are covered by the Régie de l’assurance maladie du Québec (RAMQ), the cost of PrEP will be no more than $95.31, unless you have received an exemption. If you already have recurring prescriptions that you are filling with RAMQ, the cost of PrEP will not exceed the maximum fee of $95.31. You may wish to consult the RAMQ website at www.ramq.gouv.qc.ca for more details.
If you have private insurance, the cost of PrEP will depend on your policy. Generally, annual coverage begins January 1st, and the applicable refunds can vary between providers. Every insurer has a maximum fee that you will be responsible for at the time of filling your prescription, and this information can be found in your insurance policy.
Unfortunately, due to provincial laws in Quebec, Freddie cannot legally provide any financial assistance at this time.
In Ontario, the cost of PrEP is covered for some residents automatically, and for others, there are several other options available to assist with the cost of PrEP for individuals without private insurance.
Ontario residents 24 years and younger are fully covered by OHIP+, as long as they are not on a private insurance plan as well. Anyone who falls into this category can rest assured that they do not have to enroll or register to access OHIP+ coverage.
For Ontarians 65 years and older, coverage is offered under the Ontario Drug Benefit plan (ODB). Enrolment in ODB is automatic, and coverage begins on the first day of the month after turning 65 years old.
Residents of Ontario between and including 25 and 64 years of age may be covered under a private insurance plan through their employer or educational institution. For those who fit this age group and don’t have private insurance, there are a few different governmental options to consider before looking into purchasing an individual private insurance plan.
Provincial aid is offered through Service Ontario for Ontarians with continuous or recurrent impairment or disability under the Ontario Disability Support Program (ODSP). Under ODSP, a member of the benefit is eligible for drug coverage if income support is being paid on their behalf.
For Ontarians in temporary financial need, Ontario Works may be an option that provides support with health benefits as well as financial assistance for housing, food, and other living costs.
The Trillium Drug Program (TDP) is a government-run program that assists Ontarians 25-64 years old who are responsible for paying out-of-pocket for high-cost, recurring prescriptions. TDP will help cover prescription drug costs for all eligible household members, and though an application process is required, annual enrolment is automatic.
Beyond the aforementioned provincial assistance programs, there are a few federal programs that offer prescription drug coverage and will cover the cost of PrEP, including the Non-Insured Health Benefits (NIHB) program which offers benefits to First Nations registered under the Indian Act and Inuit who are recognized by an Inuit land claim organization; the Interim Federal Health Program (IFHP) which covers certain healthcare benefits for resettled refugees, refugee claimants, and certain other groups until they become eligible for provincial or territorial health insurance; and the Treatment Benefits Program which covers anyone holding a Veterans Affairs Canada (VAC) health card.
For residents of Saskatchewan, PrEP is fully covered by the provincial government for individuals who are at a higher risk of coming in contact with HIV. During your initial consultation, your clinician will go through the criteria with you and determine your level of risk. If you meet the criteria and have a valid Saskatchewan Health Card, PrEP will be available to you at no cost.
PrEP is available for no cost through the government’s publicly funded PrEP program administered by Alberta Blue Cross. In order to access PrEP for no cost under this program, an individual must:
Alternatively, eligible First Nations individuals and Inuit may access PrEP at no cost through the federal Non-Insured Health Benefits (NIHB) program. PrEP is covered under NIHB even if the prescription is not issued by a designated PrEP prescriber.
Eventually, Freddie hopes to be able to serve all of the provinces and territories in Canada. We’re not established in the following provinces and territories yet, but here is a brief overview of what coverage looks like for PrEP across the rest of Canada:
British Columbia: PrEP in British Columbia is covered 100% the province for individuals who fit specific clinical criteria.
Manitoba: PrEP in Manitoba is not covered by provincial assistance programs. Individuals who fit eligibility requirements for certain federal programs may be able to get the cost of PrEP covered, and private insurance will be required for those who are unable to enrol in federal programs.
New Brunswick: PrEP may be covered under plans available to seniors, uninsured individuals, and social assistance programs, but co-pays may be required.
Newfoundland and Labrador: PrEP coverage is available through the provincial drug program, and there are co-pays that are defined by the program’s eligibility criteria.
Nova Scotia: PrEP in Nova Scotia can be covered through exception status via the Nova Scotia Family Pharmacare Program and requires enrolment in the Nova Scotia Family Pharmacare Program. Co-pays are defined by the family’s size and annual income.
Prince Edward Island: if approved by the chief public health office, PrEP in Prince Edward Island will be provided at no cost.
Yukon: PrEP in Yukon is not covered by territorial assistance programs. Individuals who fit eligibility requirements for certain federal programs may be able to get the cost of PrEP covered, and private insurance will be required for those who are unable to enrol in federal programs.
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