Your Guide to HIV Treatment

Paying for treatment

To cover the cost of HIV drugs, most people with HIV rely on drug insurance plans—either private plans (usually through work) or provincial or territorial plans. Some people are covered under plans from the federal government. These people include refugees, members of the military, federal government employees and retirees, federal prisoners and designated Indigenous people who are living on reserves.

Which drugs are eligible for coverage varies from plan to plan. If you have private insurance, contact your insurance company to find out which antiretroviral drugs are covered under your plan and ask about the terms of coverage. To find out about provincial, territorial and other drug benefits, talk to your doctor.

Each province and territory has a list called a formulary that includes all the drugs covered under its plan. Most antiretroviral drugs are covered on most provincial and territorial formularies. However, there may be special conditions or restrictions—for instance, certain drugs may not be covered unless you have tried other drugs first. Also, it may take some time for a newly approved drug to be included on a formulary.

There are ways you can get financial assistance even if certain drugs are not covered by your private, provincial or territorial plan, so don’t despair. Your doctor, pharmacist or local HIV organization can give you more information about paying for HIV drug treatment.

Resource

Federal, Provincial and Territorial Drug Access Programs – Information about drug coverage and benefit programs in Canada