Pre-exposure prophylaxis (PrEP) prescriptions are supposed to be free under the Affordable Care Act (ACA), but barriers persist. Some health plans don’t cover all available PrEP options (Truvada or Descovy pills and long-acting Apretude injections). What’s more, many insurers do not include lab tests and other related services. PrEP provision via telehealth increased during the COVID-19 pandemic, but a small survey by the Kaiser Family Foundation revealed that white gay and bisexual men are most likely to use tele-PrEP. The survey also found that a majority of private companies may be charging fees for tele-PrEP services. Another study, conducted before the ACA PrEP coverage rule went into effect in January 2021, showed that about 8% of people did not pick up PrEP prescriptions called in for them. People with health insurance who had a high medication co-pay were four times more likely to abandon their prescription. And people new to PrEP, women, Black people and young people all had higher rates of PrEP abandonment.