Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) carries a list price above $4,500 per month in the US — a figure that puts it out of reach for many people living with HIV without insurance or with high out-of-pocket costs. The Biktarvy patient assistance program and several related access initiatives exist specifically to close that gap. This page explains each program, who qualifies, and how to apply.
What Is the Biktarvy Patient Assistance Program?
The term “Biktarvy patient assistance program” most commonly refers to Gilead Advancing Access, a manufacturer program run by Gilead Sciences — the company that makes Biktarvy. The program has two main tracks:
| Track | Who It’s For | Benefit |
|---|---|---|
| Patient Assistance Program (PAP) | Uninsured or underinsured patients who meet income limits | Free Biktarvy, shipped to your doctor’s office or pharmacy |
| Copay Coupon Program | Commercially insured patients with a Biktarvy copay | Copay reduced to as little as $0/month (program limits apply) |
Both programs are administered through the same helpline and case management system. Your HIV specialist or primary care provider can initiate enrollment on your behalf, which is required for the PAP track.
Gilead Advancing Access: Free Biktarvy for Qualifying Patients
The Patient Assistance Program (PAP) provides free Biktarvy directly to patients who have no insurance, whose insurance does not cover Biktarvy, or who have exhausted their coverage benefits. Eligibility is based on three main criteria:
Eligibility at a glance: US residency · Valid Biktarvy prescription · Inadequate or no insurance coverage for Biktarvy · Household income within program guidelines (based on Federal Poverty Level, updated annually)
Gilead does not publish a single fixed income cutoff. Income thresholds are reviewed and adjusted annually and vary by household size. Patients whose income exceeds published limits may still qualify under exceptional-circumstances review. Your Gilead case manager will confirm current thresholds when you call.
What the Program Provides
Approved patients receive Biktarvy at no cost, typically dispensed for a 90-day supply at a time. The medication is shipped to your prescribing physician’s office or a designated specialty pharmacy. Participants are re-evaluated periodically to confirm continued eligibility.
Who Is Not Eligible
Important limitation: Patients enrolled in Medicare Part D, Medicaid, or any other federally funded healthcare program are generally not eligible for the PAP under federal law. Separate assistance pathways exist for government-insured patients — see the Medicare and ADAP sections below.
Biktarvy Copay Card: Reducing Costs with Commercial Insurance
If you have private (commercial) health insurance and Biktarvy is covered but your copay is high, Gilead’s Copay Coupon Program can reduce your monthly out-of-pocket cost to as little as $0. The card functions similarly to a manufacturer coupon applied at the pharmacy counter.
Key details for the copay card:
| Feature | Detail |
|---|---|
| Eligible insurance | Commercial/private insurance only |
| Medicare/Medicaid | Not eligible — federal anti-kickback rules prohibit this |
| Annual benefit cap | Program terms set a maximum annual savings amount (confirmed at enrollment) |
| Income requirement | None for the copay card |
| How to enroll | Call 1-800-226-2056 or enroll through your specialty pharmacy |
Copay card and Medicare do not mix. Using a manufacturer copay card when you are a Medicare beneficiary is prohibited under federal law and can expose you and your pharmacist to legal risk. If you have Medicare, use the Extra Help or ADAP pathways described below instead.
AIDS Drug Assistance Programs (ADAP)
Every US state and territory operates an AIDS Drug Assistance Program (ADAP), funded through the federal Ryan White HIV/AIDS Program. ADAPs provide HIV medications — including Biktarvy — to low-income individuals who are uninsured or underinsured, regardless of immigration status in many states.
ADAPs are among the most important access tools for people living with HIV in the US, particularly because:
· ADAPs can serve Medicare and Medicaid beneficiaries, filling coverage gaps that manufacturer programs cannot
· They are not affected by the federal anti-kickback statute that limits manufacturer copay cards
· Many ADAPs also help enrollees obtain health insurance through premium payment assistance
To find your state’s ADAP and determine eligibility, contact the National Alliance of State & Territorial AIDS Directors (NASTAD) or call the HIV/AIDS hotline at 1-800-HIV-0440. Your HIV clinic’s social worker or case manager can also initiate an ADAP referral directly.
Medicare Options for Biktarvy Coverage
If you have Medicare, you have two primary pathways to reduce Biktarvy costs — and in many cases, both can be used together.
Medicare Extra Help (Low Income Subsidy)
Medicare Extra Help is a federal program that dramatically reduces Part D prescription drug costs for Medicare beneficiaries with limited income and resources. Biktarvy, as a Part D drug, is eligible. Qualifying for Extra Help can reduce your share of Biktarvy’s cost to a modest fixed copay per fill.
To apply for Extra Help, visit the Social Security Administration’s Extra Help page or call the SSA at 1-800-772-1213. Eligibility is based on income and resources, not age.
State ADAP as a Medicare Supplement
Many state ADAPs have specific components designed to help Medicare Part D beneficiaries pay premiums, deductibles, and cost-sharing amounts that Extra Help does not fully cover. This combination — ADAP covering the gaps left by Medicare — is used routinely by HIV-positive Medicare beneficiaries across the US. Ask your care team or ADAP case worker about the Medicare Savings Benefit component of your state’s program.
How to Apply: Step-by-Step
The most direct route to the Gilead Advancing Access program is through your prescribing physician’s office. Your doctor’s office will often have experience with the enrollment process and can initiate it on your behalf.
Tell your HIV specialist or primary care physician that you cannot afford Biktarvy and want to explore patient assistance. They can confirm whether you are a candidate and begin the enrollment process.
Reach the program directly at 1-800-226-2056 (Monday–Friday, 9 AM–8 PM ET). A case manager will confirm your eligibility, explain the required documents, and guide both you and your provider through enrollment.
You will typically need: proof of US residency (state ID, utility bill), proof of income (recent tax return, pay stubs, or letter of unemployment), insurance card or documentation of no coverage, and a completed prescription from your doctor.
The physician portion of the application includes confirming the diagnosis, prescribing Biktarvy, and attesting to your clinical need. Many practices handle this routinely through their in-house patient assistance coordinator.
Complete applications are typically processed within 5–10 business days. If you need Biktarvy urgently while your application is being reviewed, ask your care team about bridge supplies or emergency ADAP enrollment for interim coverage.
Also available through your pharmacy: Some specialty pharmacies that dispense Biktarvy have patient assistance coordinators on staff who can initiate Gilead Advancing Access enrollment on your behalf. Ask your pharmacist whether this service is available.
Comparing Your Options at a Glance
| Program | Best For | Medicare OK? | Income Limit? | Contact |
|---|---|---|---|---|
| Gilead Advancing Access PAP | Uninsured / underinsured | Generally no | Yes (FPL-based) | 1-800-226-2056 |
| Gilead Copay Card | Commercial insurance copay | No | No | 1-800-226-2056 |
| State ADAP | Uninsured, underinsured, Medicare gaps | Yes | Yes (varies by state) | 1-800-HIV-0440 |
| Medicare Extra Help | Medicare Part D beneficiaries | Yes | Yes (SSA-determined) | 1-800-772-1213 |
Frequently Asked Questions
How we reviewed this article:
This page was written by Ray Ashton and medically reviewed by Dr. Neha Mishra. It covers Gilead Advancing Access, the Biktarvy copay card, state ADAP programs, and Medicare access pathways. Program eligibility criteria and contact numbers are drawn from publicly available Gilead Sciences materials, NASTAD resources, and official US government program pages. Last reviewed March 2026.
Read our editorial policy →References
- Gilead Sciences. Gilead Advancing Access Program. Gilead Sciences, Inc.
- Health Resources & Services Administration. AIDS Drug Assistance Programs (ADAP). HRSA Ryan White HIV/AIDS Program.
- Social Security Administration. Medicare Extra Help (Low Income Subsidy). SSA.gov.
- National Alliance of State & Territorial AIDS Directors. ADAP Directory and State Resources. NASTAD.org.
- Centers for Medicare & Medicaid Services. Medicare Part D Drug Coverage. CMS.gov.