Hepatitis Forums
Hepatitis C Main Forums => Considering Hepatitis C Treatment => Topic started by: Harvoni_NYC on December 12, 2014, 11:39:03 am
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I am currently frustrated. I was diagnosed a month and 1/2 ago(probably infected over a decade ago), and I went to see an infectious disease specialist. This specialist told me that she would prescribe Harvoni and that there was a 97% chance this would be cured. She said her office would fight with the insurance company to approve this drug for me. I have GHI insurance, with an Express Scripts rider for prescriptions. A week later the doctor called me and said the insurance company required that I get a liver biopsy(which was a terrible experience)...so another two weeks later I am told that I have been APPROVED for Harvoni treatment by my insurance. YAY....not so fast. Apparently there is a $17 thousand copay PER MONTH. I call MySupportPath and they tell me that the copay coupon is good for up to $23,675...but if my copay is 17k and I need to pay that for 3 months, my total copay cost is $51,000!!! So that means I will have to pay $27k out of pocket? Apparently now MySupportPath is working with my insurance to try to get this copay cost down...because if I have to come up with 27 thousand dollars I will be waiting for a loooong time to begin treatment. I am also terrified to begin my first months treatment only to run into financial issues when it is time for month two(and three). Has anyone experienced this nightmare with express scripts or their insurance carriers? I went from being very optimistic to getting a sense that this might not happen for me.
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OK...update time:
After back and forth for a couple days, the copay coupon works and my 17thousand dollar copay(Express scripts) for my first 28 days is FIVE DOLLARS! YAY. But now the copay coupon only has about 7thousand and change left on it, and I still have two months of treatment to pay for(17 thousand per month). So It looks like I still need to come up with 27 thousand dollars somehow.
I don't know how I can begin treatment tomorrow knowing that in 28 days I will have to come up with about 10 thousand and then in 28 more days come up with 17 thousand. I cannot start treatment and have an interruption in medication. I have been calling the MySupportPath number all day for two days and I never get someone, I just stay on hold for 20 minutes at which point it forces me to leave a message...hang up and call back...ALL DAY. No one ever calls back and no one ever answers. I am in a holding pattern until I find some way to get the remainder covered.
Looking for advice..should I start taking the medication and hope over the next thirty days some miracle happens with MySupportPath? I am so exhausted.