Several programs can cover the full cost of Biktarvy, whether you’re uninsured, underinsured, or struggling with copays on a commercial plan. The path that works for you depends on your income, your insurance status, and where you live. Here’s how each option works and how to access it.
Gilead’s Patient Assistance Program for Uninsured Patients
Gilead, the company that makes Biktarvy, runs a program called Advancing Access that provides the medication at no cost to eligible patients. This is the most direct route if you don’t have insurance. To qualify, you’ll need to demonstrate financial need by reporting your annual household income and household size on the enrollment form.
The application requires your prescriber’s involvement. A healthcare provider must fill out sections covering your diagnosis, medical information, and a signature authorizing the request. On your end, you’ll need to sign the form and attach documentation for all sources of income, such as a tax return, W-2, or your last two pay stubs. If you have any insurance at all, even secondary coverage, you’ll need to fax copies of your insurance cards (front and back).
Once approved, enrollment lasts up to 12 months. During that year, Gilead runs periodic eligibility checks to confirm you still qualify. About 60 days before your enrollment expires, Advancing Access contacts both you and your doctor. If you still need the program after one year, you can re-enroll by submitting a new enrollment form. The phone number for Advancing Access is 1-800-226-2056.
One important restriction: if you become eligible for Medicaid or the AIDS Drug Assistance Program (ADAP) at any point, you may not be able to re-enroll in this program. Gilead expects patients to use government benefits first when they’re available.
The Co-Pay Savings Card for Commercial Insurance
If you have private insurance but your copay or coinsurance is still too high, Gilead offers a co-pay savings card that covers up to $7,200 per calendar year in cost-sharing, with no monthly limit. This can effectively bring your out-of-pocket cost to zero if your annual copays fall under that cap.
The card only works with commercial insurance. It cannot be used alongside Medicare, Medicare Part D, Medicaid, TRICARE, VA benefits, or any other state or federally funded health plan. If you start receiving benefits from a government program while using the card, you’re required to notify Gilead and stop using it. You can apply for the card through the Gilead Advancing Access website or by calling them directly.
ADAP and the Ryan White Program
The AIDS Drug Assistance Program is a federally funded, state-run program that covers HIV medications for people who are low income and either uninsured or underinsured. Each state sets its own financial eligibility threshold, typically based on a percentage of the federal poverty level, and you must live in the state where you’re applying. You also need a confirmed HIV diagnosis.
ADAP is part of the larger Ryan White HIV/AIDS Program, which provides a broader range of services beyond just medication. Ryan White clinics can connect you with health insurance premium assistance, cost-sharing help, and other support services. If you don’t have insurance and your income qualifies, these programs can cover Biktarvy entirely. You can find your local Ryan White provider through HRSA’s website or by asking at any HIV clinic.
Worth noting: ADAP and the manufacturer’s patient assistance program don’t typically run in parallel. If you’re eligible for ADAP, Gilead generally expects you to use it rather than their own free drug program.
340B Clinics and Safety-Net Providers
Certain healthcare facilities, including Ryan White clinics, federally qualified health centers, and some hospitals, participate in the federal 340B Drug Pricing Program. This program requires drug manufacturers to sell medications to these “covered entities” at significantly reduced prices. The savings get passed on to patients, often making medications free or very low cost.
If you receive care at a 340B-eligible clinic, the facility purchases Biktarvy at its discounted rate and can dispense it to you without the full retail markup. You don’t need to apply to a separate program. Just receiving your HIV care at one of these clinics can dramatically reduce or eliminate your medication costs. Community health centers and HIV-specific clinics in urban areas frequently hold 340B status.
Options for Medicare and Medicaid Patients
If you’re on Medicare or Medicaid, you’re locked out of both Gilead’s co-pay savings card and, in most cases, their patient assistance program. But you’re not without options. Medicaid typically covers Biktarvy with minimal or no copay, depending on your state. Medicare Part D plans cover it as well, though your cost-sharing can vary by plan.
For additional help, Gilead directs government-insured patients toward independent co-pay foundations. These are charitable nonprofits with their own eligibility criteria and application processes, separate from Gilead. Organizations like the Patient Access Network Foundation and similar groups periodically open funding cycles for HIV medications. These funds can run out, so applying early when a fund opens matters. Your HIV care provider or case manager can often alert you when funds become available and help you apply.
How to Start the Process
The fastest approach is to talk to the staff at your HIV clinic or prescriber’s office. Many clinics have patient navigators, social workers, or benefits coordinators who handle these applications routinely. They know which programs have available funding, which ones you’re most likely to qualify for, and how to avoid the common paperwork delays.
If you want to start on your own, call Gilead Advancing Access at 1-800-226-2056. They can walk you through which of their programs fits your situation and send you the enrollment form. For ADAP, contact your state’s HIV/AIDS hotline or search for your state’s ADAP program online. For Ryan White services, HRSA maintains a locator tool on its website that helps you find providers near you. In all cases, have your income documents, insurance information, and prescriber details ready to speed things along.