Treatments: Cost & Coverage

Antiviral treatments are available at no or low cost to most people.

Learn more about how you can access treatment for infectious respiratory diseases.

How can I get antivirals for COVID-19 and flu?

Antivirals for COVID-19 and influenza (flu) are available with a prescription from a healthcare provider, and in many cases, from a state-licensed pharmacist. Cost and coverage options vary depending on the drug.

Insurance Coverage of Antivirals for COVID-19

The price you’ll pay for antivirals for COVID-19 varies depending on the type of antiviral and your insurance plan. Check with your insurance provider about coverage.

There are patient assistance programs, co-pay programs, and other plans to help ensure COVID-19 treatments will continue to be available at no or low cost for most individuals.

• For Paxlovid: Those who receive care from federal entities, including Health Resources and Services Administration (HRSA)-supported health centers, Indian Health Service, Veterans Health Administration, and others will have continued access to free antiviral treatments.
  • For those who have Medicare or Medicaid coverage and those without insurance: Through PAXCESS, individuals can access Paxlovid, which is provided the U.S. Government’s Patient Assistance Program operated by Pfizer.
  • For those with private (commercial) insurance: The PAXCESS program offers a co-pay savings program.
  • PAXCESS Patient Support Program | 1-877-219-7225 | paxlovid.com/paxcess

• For Veklury: Through the Gilead Patient Assistance Program (Advancing Access), eligible individuals may be able to receive financial support in accessing Veklury.
  • Gilead’s Advancing Access | veklury.com/patient-support/

• For Lagevrio: Through the Merck Patient Assistance Program (MerckHelps), eligible individuals, primarily the uninsured, who without assistance could not otherwise afford the medicine, can receive Lagevrio free of charge. Individuals who don’t meet the insurance criteria may still qualify for this program under certain circumstances and if their income meets the program criteria.
  • MerckHelps | 1-800-727-5400 | merckhelps.com/lagevrio

Insurance Coverage of Antivirals for Flu

Antivirals for flu may be covered if you have private insurance, Medicare Part D, or Medicaid. Like most medications, the price you’ll pay for antivirals varies depending on the type of antiviral and your insurance plan. Check with your insurance provider about coverage.

For those without insurance or those whose insurance plan does not adequately cover the cost of antivirals for flu, there are patient assistance programs, co-pay programs, and other plans to help support access to flu treatments at low cost or no cost.

• For Tamiflu (Oseltamivir): Through the Genentech Patient Assistance Program, eligible individuals who without assistance could not otherwise afford the medicine may be able to receive Tamiflu free of charge.
  • Genentech Patient Resource Center | 1-877-436-3683
• For Marboxil (Baloxavir): Through the Genentech Patient Assistance Program, eligible individuals who without assistance could not otherwise afford the medicine may be able to receive Marboxil free of charge.
  • Genentech Patient Resource Center | 1-877-436-3683
• For Relenza (Zanamivir): Through the GSK Patient Assistance Program (GSK for You), eligible individuals who without assistance could not otherwise afford the medicines may be able to receive Relenza free of charge.
  • GSK for You | 1-866-728-4368 | gskforyou.com

How can I get treatments for other infectious respiratory diseases?

Talk to a healthcare provider about treatment options for respiratory syncytial virus (RSV), pneumococcal disease, and pertussis (whooping cough). Cost and coverage options can vary, and there are patient assistance programs, co-pay programs, and other plans to help treatments be available at no or low cost for most individuals.