Emblem Health Covers PrEP Medications

Effective July 1st, 2020, the GHI-CBP and HIP HMO plans cover the cost of health care services and medicines for the detection and prevention of HIV, including screenings and pre-exposure prophylaxis (PrEP). This means there is no cost-sharing, including copays, coinsurance or deductibles for HIV prophylaxis (PrEP) medications.

PrEP medications are available, free of charge, when members present their GHI-CBP or HIP HMO card along with a doctor’s prescription at the pharmacies preferred by Emblem Health: Walgreens and Duane Reade. The Welfare Fund CVS Caremark card is not accepted for PrEP medications.

We understand that the coverage for these prescriptions may be cause for confusion, but we believe the savings members will experience will outweigh any initial inconvenience.

If members have been denied, they can appeal using one of the following methods:

By Phone:
1-877-793-6253

In writing by mail:
EmblemHealth
Grievance and Appeals Unit
PO Box 2844
New York, NY 10116-2844

By fax:
EmblemHealth
Grievance and Appeals
Unit
1-212-510-5320