Accessing PrEP
If you are considering PrEP, you should discuss this with a doctor experienced in HIV or sexual health to help decide if PrEP is right for you. Contact the Health Assist team who can help you find a doctor near you.
The cost of PrEP and PEP

As the medications used in the PrEP and PEP are listed on the Pharmaceutical Benefits Scheme (PBS), your OSHC will subsidise the cost of treatment. You will be reimbursed up to $50 per approved prescription item, up to $300 per calendar year (single) or $600 (couple/family). The benefit paid will be for expenses exceeding the equivalent of the current PBS co-payment amount.

For instance, if you were prescribed Truvada, the average cost is $170 per 30 tablets. The maximum reimbursement for a prescription is $50 and your out-of-pocket expense is $120. The PREP course of treatment is between three to six months. The PEP course of treatment is one month.

For example, if your prescription costs $90, you will receive a benefit of $49 ($90 less the 2020 PBS co-payment of $41). If your prescription costs $150, you will receive a benefit of $50 (as $150 less the current PBS co-payment of $41 is higher than $50). Your maximum annual limit will remain at $300 per person per calendar year.

Cost of HIV testing

If you would like to be certain of the costs before the testing:

  1. The cost for HIV testing is roughly between $50 and $200 – some or all of this will be covered under your OSHC depending on what the charge is.
  2. Ask your GP or the pathology centre for the Medicare item numbers for the test and how much they will charge for the tests.
  3. Contact us and let us know the item number and the cost. We can tell you how much will be covered under your OSHC.

To get tested, you first need to visit a GP and ask for a pathology test. Once you have the pathology prescription, contact the pathology centre and ask for the Medicare item number and how much it will cost before you take the test. You can then contact us with this information and we can tell you how much we will reimburse you.

Cost of HIV treatment
The cost of the treatment depends on the type of drug your doctor will be prescribing to you. A very simple way is to enter the drug name and words “private prescription” into a search engine to view the cost. For instance, if you were prescribed Truvada, the average cost is $170 per 30 tablets.
Where can I get tested (STI and HIV) for free?

Each state and territory manage their own sexual health clinics independently. Whilst it is a free clinic for Australian citizens and permanent residents, there are some services available to international students if you fall in the priority list due to circumstances. You can reach out to them and they will assess your situation individually.

For the nearest sexual health clinic, click on your state

Does my OSHC cover the cost of HIV testing?
Yes. We cover 100% of the Medicare Benefits Schedule (MBS). Please refer to the ‘Cost of HIV testing’ section above for a full explanation.
Does my OSHC cover the cost of treatment?
Your OSHC will provide some benefits towards the cost of your prescription medications. If the medications are listed on the PBS, your OSHC will subsidise the cost of treatment. For example, if your prescription costs $90, you will receive a benefit of $49 ($90 less the 2020 Pharmaceutical Benefits Scheme (PBS) co-payment of $41). If your prescription costs $150, you will receive a benefit of $50 (as $150 less the current PBS co-payment of $41 is higher than $50). Your maximum annual limit is up to $300 per calendar year (single) or $600 (couple/family). The benefit paid will be for expenses exceeding the equivalent of the current PBS co-payment amount.
Will my parents know what I have used my OSHC for?
No, only you and those you grant authority to can discuss your membership. When we receive a call or email, we ask for identification to ensure that we are speaking to the correct person before commencing the call. Services are identified by Medicare Item Numbers and categorised as medical. A short clinical description of the service is provided on the Benefit Remittance that is issued to you by post (only if requested by the member). For instance, if you have an STI test. It would be under a general category called Medical with the item number and a few words that describe the service.

Source: 

https://www.positivelife.org.au/latest-news/prep-access-options.html

All clinical information contained in this article/on this page is intended for general information purposes only. The information should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.

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