should I be concerned about this?

[CharlieM]

Good morning all!  Appreciate any insights from the group.

I'm on week 5 of an 8 week harvoni protocol.  Was denies 12 weeks by Cigna.  I'm in that gray zone below 6 mil vl and f3, no cirrhosis, tx naive - but doc originally requested 12 weeks.  I thought that was good.  Don't want to have to go through this again.  Signed up with support path and those folks are great, but not eligible for financial assistance because I have private insurance.  Going to appeal the denial but wife feels I should be prepared.  No particular reason to think 8 weeks won't be sufficient, but don't like an insurance co. .making my medical decisions either.   Haven't received my 4 week blood work yet, but I understand that won't really mean much for long term svr.  I'm trying to figure out if I should accept the 8 weeks and hope and pray or really push for the 12 weeks, destroying my peace of mind for the next three weeks........

[BillT]

Hi Charlie,
              You have nothing to lose by appealing it.Several people here have won theirs so I'll let them wade in on this and the how to part.I would do it just to annoy the insurance company.

[Lynn K]

I would say give it a try if you win you get the extra weeks if you don't win the appeal you will be no worse off than you are by doing nothing.

Nothing to lose and 4 weeks of additional treatment to gain

Good luck to you with appeal and treatment
Lynn

[Else]

Hey Charlie!    You can tell from my signature line what my take on this it.  Appeal, appeal, appeal!!!  Nothing to lose by doing it.

Your viral load is a fairly meaningless number from a medical point of view and it tends to fluctuate but some insurers try to use it as an excuse for shorter treatments.

Gilead (the makers of Harvoni) have studies available that you can use in your appeal justifying a 12 wk course of treatment.  And you may get denied again.

But the Affordable Care Act guarantees you the right to a third-party review.  It is at the independent review level that many denies get   overturned.  Then your insurer is required to honor that decision.  That's how it worked for me - go for it! 

[Coach Mike]

Hi Charlie,
Have you thought of ordering generics from abroad? 28 days worth of sovaldi & ledipasvir would cost about $700.00.
Mike