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Author Topic: Support Path process/Medicare  (Read 9668 times)

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Offline kauri

  • Member
  • Posts: 21
Support Path process/Medicare
« on: March 04, 2015, 07:17:33 pm »
Hi, I'm Kauri and new to the forum, though I've read it a bit. My docotr has just written me a script for Harvoni. My question is about the process ahead. I called Harvoni support, and told them I have medicare/medi-Cal, and the person on their end said, "We will pay for your medication"! I find that very hard to believe. Will they really? I have mailed their application to them.
My doctor without any reason, is confident that Medicare will approve it, in fact he thinks he doesnt even need approval, and dismissed my concerns, though he agreed to sign the Gilead Support Path form when I said they will give me support as well.
My Necroinflamm grade is A3SEVERE and my Firbrosis Stage is F3MANY.
My household income is SSI disability. I had surgery for colon cancer in 2013.
I cannot seem to get any answer about what are Medicare criteria for Harvoni approval?
And, with my doctor being so naive, how can I move the process along without annoying him?
Uncertainty is hard to live with on such big questions and it would help alot if anyone can tell me anything that will help me understand what the process is. That said, Hooray for this great breakthrough and I hope we all get treated soon.
Thanks,
Kauri
GT !a, likely infected '77 or '83 (needle or tattoo)
DX '95
'95 Interferon stopped bec. low white blood cell count
Fibrosis: F3MANY
Necroinflamm: A3SEV
Viral load at beginning of treatment: 27 million copies or 10.3 million IU/mL
HARVONI begun: March 17, 2015 12 week course

Offline sapphire101

  • Member
  • Posts: 238
  • "Stop worrying and start living"
Re: Support Path process/Medicare
« Reply #1 on: March 04, 2015, 10:35:38 pm »
Kauri I don't know the answers to your very important questions but the moderators do and they will jump in soon. Hang in there!!

2015 is the year for HCV medication breakthroughs and you will get to be a part of it
Sapphire101
Genotype 1a Fibrosis level 1
Viekira Pak with ribavirin 12 weeks
Pre treatment  VL  1.7 million, AST 45 ALT 65
EOT VL not detected, AST 21 ALT 21
12 week SVR not detected,24 week SVR not detected.
Cured! Class of 2015

Offline kauri

  • Member
  • Posts: 21
Re: Support Path process/Medicare
« Reply #2 on: March 04, 2015, 10:46:27 pm »
Thanks Sapphire101 for the kind encouragement. You're right, I can be a little patient, after all this time! I hope it's working out for you too.
GT !a, likely infected '77 or '83 (needle or tattoo)
DX '95
'95 Interferon stopped bec. low white blood cell count
Fibrosis: F3MANY
Necroinflamm: A3SEV
Viral load at beginning of treatment: 27 million copies or 10.3 million IU/mL
HARVONI begun: March 17, 2015 12 week course

Offline morning_glory

  • Member
  • Posts: 104
  • This is the first day, of the rest of your life...
Re: Support Path process/Medicare
« Reply #3 on: March 05, 2015, 01:29:43 pm »
kauri,
I'm not one of the moderators... But I want to encourage you, as sapphire101 said - "Hang in there!"

You have taken the first step, by getting the the intake form signed & mailed.  :)
Call Support Path (after several days of mailing) to see if they have received your paperwork. At some point, you should be given a 'Case #', write it down & refer to it when you call them. They are very good at letting you know the status of your case. Do be patient, as there are many people applying for support from them.

Most importantly, keep copies of everything - blood work, intake form, notes, etc.

Anytime I have called Support Path, they review their current notes on my case & give me an update. I am waiting for (hopefully) an approval for Harvoni.

Blessings,
MG
Likely infected - mid 70's / Diagnosed - mid 90's
Geno type - 1a
AST - 45
ALT - 51
Viral Load - 435,120
Liver Biopsy 6/2004 - F1-2
Fibrosure 5/2011 - F1-2
Fibrosure 2/2014 - F-0
Treatment Naive, prior to Harvoni
Harvoni started on 5/16/15
8-week Treatment Completed (7/10/15)
4-week bloodwork (6/11/15) Undetected, AST 15, ALT 17
8-week bloodwork (7/13/15) Undetected, AST 14, ALT 16

Offline kauri

  • Member
  • Posts: 21
Re: Support Path process/Medicare
« Reply #4 on: March 05, 2015, 07:32:03 pm »
Your response was very comforting, thank you Morning_Glory. Just what I needed, instead of floating around not knowing what's going on. After your suggestions, I made a folder to keep everything in, labelled optimistically, HEPC TREATMENT.
(I have ADD and so that helps me keep track). Thanks again, I hope everything is good with you.
GT !a, likely infected '77 or '83 (needle or tattoo)
DX '95
'95 Interferon stopped bec. low white blood cell count
Fibrosis: F3MANY
Necroinflamm: A3SEV
Viral load at beginning of treatment: 27 million copies or 10.3 million IU/mL
HARVONI begun: March 17, 2015 12 week course

 


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