NJ| Bulletin No 25-01, issued by the New Jersey Department of Banking and Insurance reminds health insurance carriers of their obligation to cover HIV pre-exposure prophylaxis (PrEP) without cost-sharing for individuals at high risk of HIV acquisition. The bulletin outlines the Affordable Care Act’s requirement for coverage of preventive health services, including PrEP, based on recommendations from the United States Preventive Services Task Force. It specifies that carriers must cover both oral and injectable formulations of PrEP, along with associated baseline and monitoring services, for plan years beginning on or after August 31, 2024.
Key Points:
- Carriers must cover FDA-approved PrEP formulations, including Truvada, Descovy, and Apretude, without directing individuals to use one formulation over another.
- Covered services include HIV testing, hepatitis B and C screening, kidney function tests, pregnancy testing, STI screening and counseling, and adherence counseling.
- The bulletin emphasizes that office visits primarily for delivering recommended preventive services must be covered without cost-sharing.
