Health Advocacy
PrEP
Changes to WA State PrEP DAP (Drug Assistance Program)- January 2026
The WA State Department of Health is making changes to PrEP DAP that could impact your current or future qualification or access to the program.
Changes include:
1. Change 1: New income limit of 500% of the federal poverty level (FPL). PrEP DAP started an income limit of 500% of the federal poverty level (FPL). The monthly gross income limit is $6,650 or below for 2026. * This means that your monthly gross income must be $6,650 or below for PrEP DAP coverage.
2. Change 2: Income documentation must be sent with your application to verify income.
a. Income documentation can include:
i. If you are employed:
1. By an employer: Pay stubs from your two (2) most recent months
2. Self-employed: A profit and loss statement for your two (2) most recent months (only include deductions the IRS allows, even if you do not file taxes)
ii. If you receive income from other sources:
1. Current year award letters for Social Security, Unemployment, or Pension Benefits, etc.
iii. If you receive cash income:
1. A profit and loss statement from your two (2) most recent months
3. Change 3: Individuals with insurance will likely no longer be able to use PrEP DAP as a secondary insurance, meaning they may be billed for co-pays and fees associated with the appointment.
If you submitted an application after November 30th, 2026 or your PrEP DAP is up for renewal, you will need to re-apply using the new PrEP DAP application and provide the appropriate income documentation.
The Department of Health is not currently processing applications as they build the system for income verification and have not processed applications from December 1st to present. This is causing delays in PrEP DAP approval or denial.
*** We will post the new application as soon as it is available and notify community when DOH starts processing applications again.***
Impacts on the PrEP Navigation Program at Seattle’s LGBTQ+ Center
Community members looking to schedule a PrEP appointment with the LGBTQ+ Center, can complete a PrEP appointment request and a Navigator will reach out to you to discuss options and/or book an appointment. You can no longer schedule a PrEP appointment through our website.
The LGBTQ+ Center partners with Kelley-Ross Pharmacy to offer PrEP care. Kelley-Ross is a fee-for-service provider, which means they bill insurance and may charge for appointments or labs. PrEP DAP used to cover everything, but with these upcoming changes, Kelley-Ross, or any other clinic that bills insurance, might not be able to guarantee free PrEP visits anymore.
You can learn more about KR on their website: https://www.one-step-prep.com
If you have insurance
- Kelley-Ross accepts most insurance plans
- Give Kelley-Ross a call to check whether they take your insurance and to schedule a PrEP‑start appointment. 206-641-7766. KR accepts most insurance plans.
- Depending on your plan, you may still have a copay or lab fee.
- It can help to look over your insurance benefits beforehand so you know what to expect.
According to the 2023 U.S. Preventive Services Task Force (USPSTF) update:
Insurance plans must cover certain oral and injectable PrEP medications, along with the required visits and baseline and monitoring labs, without any cost‑sharing.
That means:
- No copays
- No deductibles
- No coinsurance
Plans and issuers are required to follow this guidance. See the following federal document: https://www.cms.gov/files/document/faqs-implementation-part-68.pdf
Despite these rule changes, some insurances are not complying and people still see unexpected charges. If that happens, we encourage you to contact your insurance to appeal and reference the above federal document.
Here is more information on HIV PrEP coverage and your rights: https://healthlgbtq.org/wp-
content/uploads/2025/07/HealthHIV-Guide-to-PrEP-Coverage-and-Insurance-Rights.pdf
Please note: Kelley-Ross does not take these insurances:
- Tricare
- Veterans Affairs (VA) Care
- Kaiser CORE
- Medicare
Kelley-Ross also does NOT accept Medicaid fee-for-service. They DO accept managed Medicaid plans, including:
- Community Health Plan of Washington (CHPW)
- Coordinated Care
- Molina
- United Healthcare
- Wellpoint
If you do not have insurance:
- A PrEP start visit at Kelley-Ross costs $60–$250 out of pocket.
- To lower the cost, you can schedule free HIV/STI testing at the LGBTQ+ Center, then book a PrEP‑start appointment with KR.
- Call Kelley-Ross at 206‑641‑7766 and let them know you would like to do your testing at the Center.
Good news: Uninsured folks making under 500% FPL (~$78,000/year) that do not qualify for Medicare can still qualify for PrEP DAP. You’ll need to have your PrEP DAP approval letter before meeting with a KR pharmacist.
a. To apply for PrEP DAP schedule a PrEP Navigation appointment with a Navigator at the LBTQ+ Center. Complete this form and a Navigator will reach out to you to discuss options and/or book an appointment.
PrEP DAP Changes FAQ
Do I need to have insurance?
No, but there may be an additional out of pocket cost through the KR program.
Due to recent changes to the PrEP DAP (the WA State Drug Assistance Program), we cannot guarantee same day PrEP for uninsured individuals. To reduce the cost of your appointment, you can schedule HIV and STI testing at the Center in tandem with a KR PrEP appointment.
If you don’t have insurance and can not pay out of pocket for your medical expenses, then you must apply for PrEP DAP and have an eligibility letter approval in hand in order to book an appointment with Kelley Ross for PrEP. Once you have received the eligibility letter from PrEP DAP in the mail, then you may call KR (206-641-7766) to book a PrEP Start appointment.
What are other low/no cost PrEP options?
- Downtown Seattle Public Health Center ( 2124 4th Avenue)
- Seattle Roots (Carolyn Downs Family Medical Center/ Country Doctor)
- NeighborCare (Many locations)
- Sexual Health Clinic at Harborview (908 Jefferson St.)
What other drug assistance programs are there?
- Gilead Advancing Access Programs: https://www.gileadadvancingaccess.com/
- Prescription payment assistance
- Co-pay assistance
- Financial assistance programs through larger institutions (Swedish, Kaiser, Providence)
- Viiv Pay – Aperture co-pay assistance
About Pre-Exposure Prophylaxis
“In its simplest definition, prophylaxis means doing something ahead of time to prevent harming the body”
PrEP is one tool in the HIV prevention toolbox. When an HIV-negative person proactively takes PrEP to prevent chronic HIV, they are protected from HIV in case an exposure occurs during sex or while sharing needles. When used every day, PrEP has been shown to be effective in reducing the risk of contracting HIV by up to 99%.
What medications are used in PrEP?
PrEP — or Pre-Exposure Prophylaxis — involves an HIV prevention medication called Truvada®, Descovy® or Cabotegravir for HIV-negative people. Any of these medicines can significantly reduce your chances of contracting HIV. Truvada and Descovy are pills that you take one time per day, while Cabotegravir is an injection that you receive every 6-8 weeks. Truvada was approved for use as PrEP in July of 2012 by the US FDA, and Descovy was approved in October of 2019. Your medical provider can help you decide which form of PrEP is appropriate. When used every day, PrEP has been shown to be effective in reducing the risk of contracting HIV by up to 99%.
What is PrEP Navigation?
PrEP navigation supports people in finding HIV prevention options that meet their sexual and reproductive health needs, without shame or stigma. Through prevention education, health benefits navigation, and referrals to resources, navigation programs help people understand PrEP, resolve barriers to PrEP care, get insurance coverage, and connect people to other support services.
In addition, if you are uninsured or need financial assistance to cover the cost of PrEP, a PrEP Navigator can help you apply for drug assistance programs. Please read the notice above regarding changes in PrEP DAP.
Our PrEP Navigators Will:
- Have a conversation with you about sexual health and tools for preventing HIV
- Support you in deciding whether you could benefit from taking PrEP
- Conduct STI and rapid HIV testing
- Help you apply for drug assistance programs
- Schedule you a One-Step PrEP™ appointment with our partner pharmacy Kelley-Ross
If you are interested in PrEP, request a PrEP appointment today!
Sophie, the Center’s Clinic Manager
Frequently Asked Questions
Who are the Center's PrEP Navigators?
Each of our Sexual Health and Prevention Navigators is a Certified PrEP Navigator. Learn more about our Navigators here.
When should I book a PrEP Navigation appointment?
If you are having sex or share needles for injecting drugs, you may want to learn more about your risk of acquiring HIV. If the following characteristics apply to you, schedule an appointment with one of our PrEP Navigators today to learn more about which prevention tools are available to you.
Sexually-Active Adults and Adolescents
Back hole/anal or front hole/vaginal sex in the past 6 months AND any of the following:
- HIV-Positive sexual partner (especially if partner has an unknown or detectable viral load)
- Bacterial STI in the past 6 months
- History of inconsistent or no condom use with sexual partner(s)
In addition, if you are uninsured or need financial assistance to cover the cost of PrEP, a PrEP Navigator can help you apply for drug assistance programs. Remember – PrEP is FREE for all WA state residents.
How do I get on PrEP as soon as possible?
Book an in-person or virtual appointment with our partner pharmacy, Kelley-Ross. If you are uninsured or need financial assistance to cover the cost of PrEP, Kelley-Ross will schedule you with a PrEP Navigator at the Center to help you apply for payment assistance programs.
I'm concerned I may have been exposed to HIV
Call to learn more or schedule a PEP appointment at our in-house pharmacy: Kelley-Ross
Phone: (206) 641-7766
Fax: (206) 641-7767
Email: [email protected]
For More Information About PrEP, Please Visit:
- Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update Clinical Practice Guideline – by the CDC
- Helping People Access Pre-Exposure Prophylaxis – by pleaseprepme.org
- Pre-Exposure Prophylaxis (PrEP) – by the DOH
