In our life, anyone can get affected by diseases. At that time, you should look for medicine to overcome the disease. Biktarvy is a complete treatment for HIV infection in adults and children.
People who get affected by HIV are unlucky. The cost of HIV medicine is high. But if you are covered by an insurance plan that covers Biktarvy, you can bear the cost more effectively.
I still remember how my friend fought with HIV disease during COVID-19. The job became easier because he got proper medical coverage in paying Biktarvy costs.
Right now, a question comes to your mind “Is Biktarvy Covered By Insurance.” Isn’t it? Well, the simple answer to this question is yes. Nevertheless, do you want to know more about insurance coverage for Biktarvy? If yes, keep continuing your reading.
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Does insurance cover Biktarvy?
Most health insurance plans cover Biktarvy. However, on insurance plan formularies, Biktarvy occupies a higher tier. As a result, insurance plans may only cover some of the cost of the medication.
Although copay costs may vary, Medicare insurance plans may assist in paying the cost of Biktarvy. Eligible patients can afford Biktarvy through Medicaid, the largest payer of HIV/AIDS medical treatment in the United States.
However, the insurance plan’s formulary, copay, and deductible will determine the cost. If you have insurance, check with your plan provider to find out how much Biktarvy will cost under your plan.
Biktarvy is partly covered by most U. S. commercial and government health insurance plans. Biktarvy users pay between zero and nine dollars a month.
- Commercial Insurance
The monthly cost of commercial or employer-sponsored insurance is between zero and five dollars. You must contact your insurance provider to determine if your plan covers Biktarvy.
- Medicare
The cost of Biktarvy will be covered by Medicare, the federal health insurance program for Americans over 65. A person with Medicare pays between zero and five dollars monthly.
- Medicaid
Medicaid covers Biktarvy. Medicaid is a health insurance program run by the government of the United States that helps low-income people and their families pay for medical care. A person who uses Biktarvy pays between $4 and $9 a month.
Gilead Advancing Access Program: Financial Support
Gilead Advancing Access Program provides financial support to pay for your medicine. If you are uninsured, underinsured, or have no insurance, they can help you. Advancing Access can reduce your copay to zero dollars if you qualify. Gilead helps you and your doctor if your insurance company does not cover your Biktarvy prescription.
Take note that Gilead Advancing Access and the copay card are unavailable if you have government-sponsored insurance. Instead, if you want to save money on your prescription, check out these recommendations from the drug’s manufacturer, for example, Medicare.
What is the price of Biktarvy without insurance?
Is Biktarvy Covered By Insurance? Yes, it does. Medicare and Medicaid insurance programs, and private insurance policies, cover Biktarvy. Yet, there is no generic Biktarvy, which can be expensive without insurance. Nonetheless, various options are available to people without insurance to reduce the cost of Biktarvy.
Biktarvy (30, 50-200-25 mg tablets) costs $7,797/ mo without insurance or slightly more than $90,000 for a year of treatment. The quantity and dosage prescribed by a healthcare provider and the location from which the drug is bought will influence the medication’s final cash.
Process of getting Biktarvy without insurance
Biktarvy treatment may be too expensive for many people without health insurance or financial aid, with an annual cost approaching $90,000. The manufacturer “Gilead Sciences” offers a patient aid program called the “Gilead Advancing Access Program” that may help insured or uninsured patients who meet certain criteria save money on Biktarvy.
- Use a SingleCare savings card to get started
People can cut the monthly cost of Biktarvy by 50% by using a SingleCare discount card. Compare potential savings at the nearest pharmacies by looking at the current discounts on SingleCare’s Biktarvy coupon page.
- To receive free or low-cost HIV/AIDS medicines, enroll in ADAP
The AIDS Drug Assistance Program (ADAP) may assist people without insurance in paying for HIV/AIDS drugs. Because the criteria are set at the state level, the ADAP formulary and eligibility requirements differ.
You have to contact your state’s health department for eligibility information, applications, and more. Sadly, some ADAP prescriptions may be on a waiting list in some states.
The HarborPath ADAP Waiting List Program may be able to provide Biktarvy or other pharmaceuticals donated by pharmaceutical companies at no cost or at a low cost if that is the case. A prescribing healthcare provider can assist the HarborPath ADAP Waiting List Program enrollment.
- Ask the doctor about generic regimens for HIV/AIDS drugs
Biktarvy, a combined HIV/AIDS medication, can be expensive. However, the FDA has authorized several low-cost generic HIV drugs. Individual drugs can be bought as generics rather than a single brand-name medication. Before purchasing alternative medication, you should contact a medical practitioner.
- Consider health insurance
Health insurance can sometimes be the best way to save money for medical conditions like HIV/AIDS that necessitate expensive, long-term care. To get a general idea of the cost and quality of commercial health insurance policies in your state, go to the health insurance marketplace.
- Apply for Medicaid
Medicaid health insurance may be a good option for those who cannot afford commercial insurance. The eligibility requirements can be found on the Medicaid website for your state.
- Utilize a 340B supplier
Certain hospitals, clinics, and outpatient care providers can save money on drug purchases through the 340B program. The savings can then be passed on to low-income or uninsured patients by these 340B providers.
Through a local provider, such as a community health clinic or hospital, you can get Biktarvy at a low cost. A list of local 340B providers can be acquired from your public health department.
General guidelines about Biktarvy
You should follow the following guidelines when you take Biktarvy.
- If you have any questions, you can ask your pharmacist or doctor.
- If you miss a dose, do not take more drugs to make up for it.
- The medicine should be kept in a tightly sealed container at room temperature, away from light, moisture, and heat.
- Do not stop taking this medicine without consulting your doctor first. The virus may become more difficult to treat if you stop taking the medicine, even for a short time.
- How much medicine to take will be determined by your doctor. Use less than recommended.
Common Biktarvy side effects
The manufacturer lists the most typical adverse effects as follows:
- Diarrhea.
- Nausea.
- Headache.
- Fatigue.
- Atypical dreams.
- Dizziness.
- Insomnia.
Additionally, the manufacturer states that less than 2% of clinical trial participants experience the following side effects:
- Vomiting.
- Gas.
- Indigestion.
- Pain in the back.
- Rash.
- Depression.
Additional Biktarvy side effects
- Increased blood levels of bilirubin.
- Heightened levels of cholesterol.
- Increased levels of amylase.
- Abnormally low levels of neutrophils.
- Elevated levels of liver enzymes.
- A rise in creatine.
- Decrease in bone mass.
- Stiffness in the joints.
- Ached muscles.
- A stuffy nose or cough.
- Sensations of burning or stinging.
- Neuropathy in the periphery.
- Triglycerides are high.
- Urine with blood.
- A rise in blood sugar levels.
- Urine sugars.
Biktarvy can cause serious side effects, which are less common but may necessitate immediate medical attention. Biktarvy’s serious side effects include the following:
- Deterioration of hepatitis symptoms in HIV and hepatitis B (HBV) patients.
- Alterations in your immune system, including a serious condition known as Immune reconstitution syndrome.
- Autoimmune conditions.
- Kidney failure and toxicity.
- Elevated blood levels of lactic acid (lactic acidosis).
- Liver enlargement or liver toxicity.
- Suicidal ideas.
Skin side effects like rashes
Some people may develop a rash from bitterness. A clinical trial conducted by Biktarvy manufacturer GILEAD Sciences found that less than 2% of participants had developed a skin rash by week 48 of treatment.
Steven-Johnson Syndrome and toxic epidermal necrolysis are two adverse effects of Biktarvy that resemble rashes. Although both are unique, in that case, you should consult your doctor immediately.
Steven-Johnson Syndrome results in painful body sores or lesions when the top layer of skin dies and separates from the lower layers. It has flu-like symptoms like fever, chills, fatigue, and muscle aches.
Another serious condition is toxic epidermal necrolysis. It can prompt broad scarring, vision trouble, and even demise. The skin’s top layer can die and separates from the lower layers, resulting in large blisters and widespread peeling. If you take Biktarvy and develop a rash, go to the doctor immediately.
Weight gain and Biktarvy
Antiretroviral therapy has been associated with weight gain in studies. Although not mentioned in the FDA-approved labeling, Biktarvy may alter body fat and lead to weight gain. It needs to be clarified why this happens, but it could be because of changes in metabolism in the body or the medicines themselves.
How long do the side effects of Biktarvy last?
As the body adjusts, mild Biktarvy side effects decrease within a few months. Nevertheless, some adverse effects may last longer, for example, headaches, fatigue, diarrhea, and stomach pain.
Biktarvy side effects that are more severe may necessitate immediate medical attention—for example, rash, liver toxicity, kidney toxicity, pancreatitis, lactic acidosis, enlarged liver, pancreatitis, and new or worsening hepatitis B symptoms in HIV-positive individuals.
Frequently Asked Questions
You may have many queries about “Is Biktarvy Covered By Insurance.” Hence, I have included some important questions to help you learn about Biktarvy and insurance.
How much does Biktarvy cost if you do not have insurance coverage?
The price of a Biktarvy with insurance and without insurance can differ. This is because the cost of Biktarvy is determined by several factors, such as the pharmacy you use and your insurance coverage.
Talk to your pharmacist about the monthly cost of Biktarvy, whether you have insurance or not. You can talk to your insurance company if you have it.
Does the manufacturer of Biktarvy provide a copay coupon or card?
Yes. Gilead, the manufacturer of Biktarvy, provides a copay card.
Is a generic version of Biktarvy available?
There is no generic version of Biktarvy. And that is why the cost of Biktarvy is high.
Why do brand-name drugs and generics have such different prices?
Brand-name medicines are safe and effective, but years of research and testing are required. The drugs may be more expensive due to this testing. A brand-name drug can be sold for up to 20 years by its manufacturer. After that, generic versions can be made by other drug manufacturers.
This market competition may result in reduced generic drug prices. Furthermore, no further research is required because generic drugs have the same active components as brand-name pharmaceuticals. As a result, generic prices may decline.
Which drug tier includes Biktarvy?
There are five tiers in most plans. Biktarvy is included in the formulary of Medicare prescription drug plans in Tier 5.
Which medicine should you avoid while taking Biktarvy?
You should avoid Dofetilide, and Rifampin while taking Biktarvy. Otherwise, you can experience serious side effects.
Are there any coverage restrictions for Biktarvy?
Biktarvy coverage is limited by some Medicare prescription drug plans, which may include the following:
1. Medicare prescription drug plans cover Biktarvy.
2. All Medicare prescription drug plans cover this medication. Quantity limits are included in most Medicare prescription drug plans to limit the number of pills that can be bought.
Is Biktarvy covered by government health insurance?
Yes. Biktarvy covers by government health insurance. For example, Medicare covers Biktarvy in its plan.
Final Thoughts
Biktarvy is one of many life-saving HIV treatments that can be received at a low cost or for free through different methods and resources.
There is no generic version of the HIV medicine Biktarvy. Thus, you should be covered by the health insurance plan if you get affected by HIV, and your doctor suggests Biktarvy as medicine.
However, the article “Is Biktarvy Covered By Insurance” gives you a clear idea about Biktarvy and insurance. Contact your nearest health insurance provider to see if they cover this medicine in their plan.
Mehedi Hasan is an insurance expert with over 6 years of experience in the industry. He has a deep understanding of various types of insurance policies and is skilled at helping clients find the coverage that best fits their needs. In his current role, Mehedi works as a consultant, advising businesses and individuals on the best insurance options for their specific situations.
He is also a frequent speaker at industry events, sharing his knowledge and expertise with colleagues and professionals in the field. Mehedi holds a degree in insurance and risk management and is committed to staying up-to-date on the latest industry trends and developments. In his free time, he enjoys reading, traveling, and spending time with his family.