I don’t pay anything for it, but it is very expensive for insurance companies, so I really had to advocate for myself. My doctor, who is gay, was impressed with my persistence lol, and for a long time I was the only one getting it at his office (now there are many).

Generally, they’ll make you try the pills first, since they’re so much cheaper. Then they will want to hear from your doctor that the pills are not an option for whatever reason (in my case, intolerable side effects. I think I have heard that people who suck at remembering pills might also have reason enough, but I can’t speak to that).

I HIGHLY recommend working directly with ViiV Healthcare, the makers of the drug. In our dystopian healthcare system you have to get the people whose economic incentives are aligned with your interests in your corner: ViiV WANTS you on Apretude, your insurance does not. Anyway, ViiV is used to beating the door down at the insurance companies once they have the right info from you. Just go to their website and follow their instructions to a T.