Truvada (emtricitabine and tenofovir DF) Medicaid Fee-for-Service

Truvada (emtricitabine/ tenofovir disoproxil fumarate) is a medication used for Post Exposure Prophylaxis, Pre Exposure Prophylaxis and treatment for HIV-positive individuals.

Post Exposure Prophylaxis (PEP)

PEP (Truvada plus Raltegravir) is prescribed for 28 days.  A 'stat pack' for 3-7 days is given in the emergency department and prescriptions are given for the remainder of the days.

  • PEP is a medical emergency and does not need Prior Approval.  A prescription for 28 days or less will have an 'auto bypass' in the Medicaid fee for service system.
  • If for some reason this does not occur you can call Magellan at 877-309-9493 and tell them the prescription is for PEP and this should resolve any issue.

Pre- Exposure Prophylaxis (PrEP)

Pre-Exposure Prophylaxis consists of taking Truvada once daily by an HIV negative person to remain HIV negative.

HIV Treatment

A person new to the Medicaid system:

Medicaid Fee for Service (FFS)

Medicaid Managed Care