Hepatitis Forums
Hepatitis C Main Forums => Post Hepatitis C Treatment => Topic started by: Harvoni_NYC on December 10, 2014, 11:32:09 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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Harvoni_NYC
If you make less than $100,000 a year (household) Gilead will send it to you for free. Didn't know if you knew that.
I used express scripts also with my BC/BS and got a couple so my out of pocket is $5.00 a month. ( Acredo is the pharmacy for the Harvoni with Express Scripts)
Sure hope you get the $$$ down!
Keep us posted.
Rooting for you for sure!
Jill
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Gilead directly..., or mysupportpath? I have been getting nowhere with mysupportpath.
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My insurance covered mine but I've seen quite a few people on here posting about the Harvoni treatment being free if your family household is less that 100,000 a year.
Maybe you could private message Lucinda or Mike for more specific info.on this.
I'll try to look online now and see too.
Jill
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http://www.gilead.com/responsibility/us-patient-access
All the info is here. Maybe because you have some insurance it won't work for you. That's a shame if that's the case.
Because that's a lot of money.
please let us know what you find out.
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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.
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Hi Harvoni_NYC
you will probably get more people to help you if you post in "considering" or "on treatment" in the support forum.
You are in "post" treatment. Just a thought..........There are a lot of informed people who can help you. I'd give it a shot if it were me.
I bet you are exhausted. so frustrating.
Jill
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I just pasted this into those two categories. Hopefully I can get some Info.
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Hi NYC,
I was sent a new coupon every month when I was on treatment.
Are you sure the coupon is for the entire treatment time or is a new one issued every month?
Best wishes, Mike