How to use Truvada Co-Pay Coupon Card with Kaiser Permanente
Truvada (PrEP) is expensive. Very expensive, so that most insurance do not cover full cost and patients usually end up paying hundreds of dollars every month, that is after insurance. But do not give up a hope yet. There's a program called Gilead Advancing Access Co-pay Program. Basically it is a Coupon Card you show to the pharmacy and you pay the discounted price. It covers up to $3,600.00 a year. Not bad.
Here I will not talk about what is Truvada (PrEP) or how to get the prescription. That you need to talk to your doctor and he/she will refer to the specialist if necessary.
This page is a memo to myself as well as to those who are in the same situation as me, having Kaiser Insurance plus trying to use this Co-Pay Coupon card.
I had Anthem Blue Cross insurance previously. The process was very easy, just show the coupon card with the prescription to the Pharmacy and the pharmacy took care of the rest. (In my case Rite Aid) There was nothing else I needed to do, no paper work, nothing. That is until my company changed the insurance to Kaiser Permanente.
I had Anthem Blue Cross PPO so I could go to any doctor, any pharmacy, then now suddenly I can go to only Kaiser. The transition was not smooth to be honest, especially the prescription transfer and Truvada Co-pay Coupon part. Because of this I had to skip Truvada for several days as I ran out before I could get the refill at Kaiser Pharmacy.
Straight to the point, Kaiser Pharmacy does not accept the Truvada Co-pay Coupon Card. (Or any coupon/discount card they said.) What they tell me is that I need to file for reimbursement. But where? And How?
My struggle started here. I found a web link to the form that I need to fill out and send it to them for the reimbursement, but there's an instruction that says send the "Pharmacy Receipt" with the form. What is a Pharmacy Receipt? I googled but couldn't find a clear answer. So I went to the Kaiser Pharmacy where I got my Truvada, and asked for a Pharmacy Receipt. But then they also did not understand the Pharmacy Receipt. They said they can give me the copy of the Rx Label and that's the only copy that they can give me.
OK, I settled for the copy of Rx Label, and at the end I successfully received a check for the amount I paid to Kaiser for Truvada. Below explains how to use this Co-pay Coupon Card with Kaiser Permanente insurance. I hope it helps those who are interested in Truvada with Kaiser.
Getting Truvada from Kaiser Pharmacy
- Getting a prescription for Truvada is the very first step. Talk to your home doctor and tell him/her that you are interested in getting on Truvada (PrEP).
- When you get the prescription, some doctors give you the Gilead Advancing Access Co-pay Coupon Card, if not ask if he/she has one. I received one from my previous doctor, but not Kaiser doctor. Once you have the Co-pay Coupon Card, activate it from this page. Or apply one from this page if you did not get it from your doctor.
- So you got a prescription and Co-pay Coupon Card, now go to the Kaiser Pharmacy where you are picking up Truvada. Check in with the Pharmacy and nervously wait for your name or number to be called. At this stage, no need to present the Coupon Card.
- Prepare to be shocked. Depends on what type of Kaiser insurance you have, the 90days supply of Truvada ranges from $250 to over $1,000. Could be less, could be more. Often times, the first month supply is more expensive due to the deductible. Fear not, I paid over $1,000 for the first month, then it was $250 thereafter. And yes, I got my reimbursement check!
- After scanning the med, the pharmacist may ask you "Are you aware the price of this???" Then keep it cool, pretend it's not a big deal at all and tell them that you are going to file for reimbursement and need a copy of the Rx Label. Yes, a copy of the Label that is taped around the Rx bottle. They know what to do and give you a copy without any problem.
- Now swipe your credit card! You will need the credit card receipt too, so don't lose it.
File for Reimbursement
- So you've got Truvada, now it's time to file for the reimbursement. Go to this page and follow the instruction. Your will be asked to enter the Co-pay Coupon Card ID number, name, address etc. At the last step, print out the Rebate form.
- Section 1 should be already filled out. Enter the necessary information in Section 2.
Do you have prescription insurance [X] Yes
If Yes, my prescription benefit provider is: Kaiser Permanente
My insurance covered: [X] All except copay of $XXX <- price you paid here
This prescription was filled at [X] a retail pharmacy store
Read and check the last part then sign and date.
- OK, I skipped the Section 3. It says "Pharmacy Receipt/Invoice Required." Now here's a problem. No matter how you explain, how many times you ask to whoever working at the pharmacy, Kaiser Pharmacy does not have such thing called Pharmacy Receipt. (At least at the Kaiser I go to) I asked 3 different people working at the Kaiser Pharmacy and failed. They told me that the copy of the Rx Label is the only thing they can give me. Rx Label has everything Section 3 asks for, so use this as a Pharmacy Receipt.
- OK, now all ready to mail. Here's the check list.
Patient Rebate Form that you printed out, all information filled signed and Dated.
Copy of Rx Label
Cash Register Receipt with RX number and price highlighted or circled.
It may not be necessary but I highlighted the Rx number and price on the copy of Rx Label as well. Now send all 3 to the address on the Rebate Form and wait.
Get the Reimbursement Check
- I filed for the reimbursement twice in the past and successfully received checks. It will take about 2 weeks.