Hepatitis Forums
Hepatitis C Main Forums => Considering Hepatitis C Treatment => Topic started by: J.R. on February 06, 2016, 01:37:15 am
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I had may bi-annual check-up with my GI doctor and told him I am ready to start treatment. I've been lurking on these pages for a while reading responses, stories, fears, and triumphs. I know it may/will be a waiting process for approval. After my test results (below) came back, doctor recommended 8 weeks of Harvoni. My biggest worry is getting insurance approval w/o appealling 2-3 times. Anyone else have Anthem Blue Cross success first time? My doctor has said not too worry about approval. Stated he's only had one patient not approved. I am hoping to start by month's end
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Welcome, J.R. Although Anthem used to approve only F3 and F4, as of the beginning of 2016 they now approve F0-F4. I took all required tests by May 15, and I received Anthem's approval letter in early July. Hordes of people were seeking Harvoni then; I understand from my hepatologist's nurse that the number of new patients has slowed considerably since then, so perhaps the interval from request to pills-in-hand is shorter now.
Best of luck with your treatment.
Gnatty
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Hi,
Never too soon to get well! Start the insurance ball rolling. You might want to look at Dr. James Freeman's REDEMPTION clinical trial. No placebos. If you've been lurking about here, you have probably read about it. There is a topic covering the trial.
The insurance will probably cover your 8 week tx, but you might have to take it to the external review. We are talking months here, not weeks. I would also go with 12 weeks. Three percent is not much unless you are one of the three.
Good Luck!
CM
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Congratulations on making the right choice to seek treatment!
I have Anthem Blue Cross, i did have F3-F-4 bridging fibrosis but I was approved first request, withing 2 weeks last year.
But because my insurance used Express Scripts they tried to substitute Vikera pak for Harvoni at the time. Express Scripts had a special price deal if they used Viekra as the treatment of choice.
My doctors fought it and after 1 denial from Express Script I was approved for Harvoni through Express Scripts specialty pharmacy Accredo.
My xperience was easy did 12 week tx undetected from week 2 to 6months EOT. Very few side effects and for me nothing major.
Go fo it, it cant get easier than 1 pilla day for the duration.
Good luck
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The (approval)wait is over. Just received confirmation, pharmacy will be shipping my first Rx after Presidents Day. Very glad didnt have to fight for treatment through the appeals process and prolong the waiting.
Sixfootfour- My Rx is through CVS-Caremark and I knew they signed an exclusive for Harvoni. My doctor said that would help the process as we wouldnt have to fight as you did for Harvoni.
Now, I just hope I have little to no side effects during Tx.
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Good for you!
That will inspire others to go for what is rightfully theirs!
I have kept up with hundreds of people taking Harvoni. Most report only a dull headache the first few days. That's it.
Please consider sharing your experience at the Delphi link below. It is not just about generics. Its about affordable treatment. Getting insurance coverage definitely qualifies.
http://forums.delphiforums.com/generichcvtx
You are on your way!
CM
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Congratulations JR !
Best of luck with your treatment. The single best advice I can share is hydrate, drink a lot of water during treatment, for many of us that reduced or eliminated most side effects of headache and/ or nausea which was all I really experienced. In fact during TX I thought I had over all more energy.
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Wow! FOUR DAYS from application to approval? Very nice ;D
Contacted my doc's nurse this morning and the fibroscan just came in yesterday. It indicates compensated cirrhosis (she didn't specify F1 - F4, but the tech who did the scan said F4(!)) and my doc is putting in for Harvoni 24 weeks for me. Your lack of wait time is encouraging.
Best of luck, J.R. May any/all your sidefx be of the positive sort. 8)
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Hi Jon
You need to stay on your doctor and follow through to start treatment if you can get it approved.
F1-F3 is Fibrosis, F4 is cirrhosis. its important that you get clear dx and proper treatment. If you are F4 at whatever level you should easily qualify for TX. Early in the process last yr some companies were holding out if you did not have at least F3-F4 but that is changed
Good luck!
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Thank for clearing that up for me, 6'4. Bad luck that it's F4, but at least I know now.
I shall stay on my doc until I have pills to take. That nurse is going to get sick of me ;)
Many thanks
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Jon
Just stay on your doctor to get you the meds. Liver can repair a lot of damage get that HepC undetected ASAP
Best of luck
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Yessir I will, and thanks a bunch.
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Flaco- actually it was 9 days. He had to wait for the lab work before submitting the papework. He originally told me it would take about 3-4 weeks. I never called insurance or doctor. Needless to say I was pleasantly surprised how fast it was expedited. When I got home and a VM to call. I thought for sure it was a denial since I wasnt a F3-F4.
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Flaco- actually it was 9 days. He had to wait for the lab work before submitting the papework. He originally told me it would take about 3-4 weeks. I never called insurance or doctor. Needless to say I was pleasantly surprised how fast it was expedited. When I got home and a VM to call. I thought for sure it was a denial since I wasnt a F3-F4.
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Welcome to the cure train J.R.,I hope the treatment goes as easy for you as the approval process. 8)
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JR, you and I will be on similar paths, as I just found out I'm approved for Harvoni, too! I've been waiting a year, but at least this ball is going to start rolling. Sounds like I will be getting my meds in 1-2 weeks. Now the real fight begins! FT
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Congrats JR. Here's hoping treatment will be a cake walk for you. :)
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Thanks all for the support. This Tuesday is the expected delivery. The only other times I've felt this much anxiety, stress, and doubt was the birth of my kids and day I got married. I initially was going to wait another two weeks to start taking Harvoni (vacation) because of any potential side effects. But the more I read others stories here and other sites and how tolerable any side effects have been, the more I'm inclined to rethink starting ASAP.
Futurethinker- Congrats! I've been waiting for some time too for a cure like this to come along. My GI told me since my diagnosis that I had time on my side since I wasnt showing any signs of Hep and no signs of damage. Well! Now my time has come!
Philadelphia- Thanks and hopefully its a smooth ride. That was my second biggest fear next to getting approval from insurance
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The sooner you start the sooner you're cured. :)