I am not a doctor, but I am a patient on treatment for HBV, and I work in the health insurance industry in the US. I would personally say that it would be best to try one of the generic options for treatment (entecavir or TDF), unless you have contraindications that would require you to use Vemlidy, just because they are so much cheaper. Insurance will usually give you less of a hard time about filling prescriptions for generic drugs, but even if they refuse to fill it, there are several options to get both TDF and entecavir for a reasonable price without insurance. I am able to get mine with a 90 day supply, and I am able to get the next fill 1-2 weeks before I’ve run out. GoodRx and Cost Plus pharmacy are great options to find good deals on generic drugs. This would also help with your worry about accessing medication if you lose access to your insurance. You can get these generic options for ~$20/month, and most people would be able to afford to pay that. It might even end up being cheaper to buy these with the GoodRx discount program than it would be to pay with insurance. I know lots of people who have insurance, and they still get their meds this way.