How to Help SelectHealth Members Access PrEP
As a provider, you play a vital role in HIV prevention—educating patients, assessing risk, and prescribing PrEP when appropriate. PrEP is recommended by the New York State Department of Health for individuals aged 12 and older who weigh at least 77 lbs, as part of a comprehensive HIV prevention strategy.
PrEP Access & Coverage Overview
| Coverage Available | Medications Covered | Key Considerations |
| NYRx Medicaid Pharmacy Program – Pharmacy Benefit | Truvada, Descovy, Apretude | May require Prior Authorization (PA) Call Magellan (NYRx): (877) 309-9493 Fax PA form: (800) 268-2990 Use PAXpress for web-based PA requests Use CoverMyMeds for web-based PA Requests Clinical call center: 24/7[SO4] |
| SelectHealth (VNS Health) – Medical Benefit | Apretude (injectable only) | Covered under medical benefit For coverage questions, call Provider Services: (866) 783-0222 |
For more information, clinical guidance, or patient resources, visit the NYSDOH PrEP provider page
Source: https://www.vnshealthplans.org/health-professionals/news/how-to-help-your-patients-access-prep/