Hep C Discussion Forum

Members Login
Username 
 
Password 
    Remember Me  
Chatbox
Please log in to join the chat!
Post Info TOPIC: Pinch me please!


Veteran Member

Status: Offline
Posts: 47
Date:
RE: Pinch me please!
Permalink  
 


Hi Tig,

Thanks for the tip! I just checked the formulary for my Medicare Advantage HMO for 2018 and found it interesting that Harvoni and Epclusa were covered but Vosevi and Mavyret were not. Not a problem for me as my hepatologist insisted Epclusa was the best treatment for my genotype 2 HCV with 99% success rates documented.

For someone new to Medicare and deciding options do your due diligence, make sure the plan you choose covers the DAA your hepatologist thinks is the best fit for you. I had already chosen my plan and lucked out (thank God!) You can only change plans during a yearly window from October 15 to December 7.



__________________

Male, 65, Dx 1990, GT 2a/2c. Pre-treatment VL 11,500,000, ALT 10, AST 18, Fibroscan F3, 12.4 kPa. Rx 12 weeks Epclusa, SOT Mar 8, 2018, EOT May 30, 2018. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18.

Tig


Admin

Status: Offline
Posts: 8024
Date:
Permalink  
 

Hey John,

Don‘t forget, that entire $6100 is deductible on your taxes. It will reduce your out of pocket expenses a little bit! We have to take advantage of every opportunity!



__________________

Tig

61 yo GT1A - 5 Mil - A2/F3 - (1996) Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ   Lab Ref. Ranges

Signature Line Set Up/Abbreviations   Payment Assistance

 



Veteran Member

Status: Offline
Posts: 47
Date:
Permalink  
 

I was fortunate: Medicare used a specialty pharmacy that would ship to me FedEx or I could drive an hour and pick up and pay in person. I chose to make the drive each month rather than risk missing FedEx. Somehow it was comforting to have the pharmacist hand me the Epclusa personally. I was worried FedEx might lose a $25,000 bottle of Epclusa. Total cost to me was $6100 for 12 weeks, Medicare paid the rest.



-- Edited by lamassu on Friday 1st of June 2018 12:35:46 AM

__________________

Male, 65, Dx 1990, GT 2a/2c. Pre-treatment VL 11,500,000, ALT 10, AST 18, Fibroscan F3, 12.4 kPa. Rx 12 weeks Epclusa, SOT Mar 8, 2018, EOT May 30, 2018. Week 2 VL 50, ALT 12, AST 21. Week 10 VL not detected, ALT 12, AST 18.



Senior Member

Status: Offline
Posts: 179
Date:
Permalink  
 

iris, yes, it all unfolds perfectly eventually.

our meds  were delivered via fed-ex and someone had to sign for them. they gave us the exact date they'd be here but a wide time.



__________________

GT1a for 36yrs .Started Intron-A in 96' for 2.5mo-VL still too high.taken off.

3.6.18:Alpha 2-Macroglobulins, Qn=400/high. A1 activity.  f3@60: fibrosur bloodtst. TumrMrk=norm. enz=mostly norm.VL=3,933,000 

.sot=5.1.18>Harvoni>[8wks]: 4WEEKS=UND. 

Tig


Admin

Status: Offline
Posts: 8024
Date:
Permalink  
 

Don’t worry, Iris! I have that feeling, and it never lets me down. Your time to Tx is near!



__________________

Tig

61 yo GT1A - 5 Mil - A2/F3 - (1996) Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ   Lab Ref. Ranges

Signature Line Set Up/Abbreviations   Payment Assistance

 



Guru

Status: Offline
Posts: 744
Date:
Permalink  
 

Yea, now it's  a wait again situation. The insurance said call the pharmacy, uh...well, they didn't have any rx for me. Lady said she only saw request back in Jan of 2017...that must have been the time they called me, boy did that get my hopes up.

Now we are back to the ID number snafu from the beginning of the year, (a very long story) Anyhoo called the insurance gal back and told them the trouble, she saw it was the ID number problem as well as it appeared the dr. was sending to the wrong pharmy. I called tthe dr. today too but they did not call back. We'll have to deal with this tomorrow says insurance gal.

Sigh...hurry up and wait...Ive waited this freaking long, suppose a couple few weeks isn't  going to make a difference now. And as I understand these meds will be delivered by mail. Just gotta make sure husband will be on the lookout (he's not coming on the trip.) 

Signing out, Iris



__________________

in the silence of the woods, you will not be alone- Chief Seattle

58 years on planet, Female, diagnosed 1976 as non a non b, VL 3mill+, Fibro f-1f-2, Genotype 1a, treatment naive 

Tig


Admin

Status: Offline
Posts: 8024
Date:
Permalink  
 

Congratulations Iris! That’s wonderful news and long overdue. You’ve been working on approval for years and I’m so happy to hear that somebody finally figured out the error of their ways.

If you can pick up your medication and store it at home, without requesting a delay, do it. Otherwise, follow their advice. If anyone hesitates, I’d resort to the former...

127281CE-A064-4FFB-8584-1FC7BADB5BA1.jpeg



__________________

Tig

61 yo GT1A - 5 Mil - A2/F3 - (1996) Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ   Lab Ref. Ranges

Signature Line Set Up/Abbreviations   Payment Assistance

 



Senior Member

Status: Offline
Posts: 179
Date:
Permalink  
 

iris, let them know ahead of time that you need to postpone tx till you are back in town. [doctors and pharmacy]



__________________

GT1a for 36yrs .Started Intron-A in 96' for 2.5mo-VL still too high.taken off.

3.6.18:Alpha 2-Macroglobulins, Qn=400/high. A1 activity.  f3@60: fibrosur bloodtst. TumrMrk=norm. enz=mostly norm.VL=3,933,000 

.sot=5.1.18>Harvoni>[8wks]: 4WEEKS=UND. 



Guru

Status: Offline
Posts: 895
Date:
Permalink  
 

Congratulations, denied three times? These insurance companies are sure fast to take our money and slow to cough up aren't they! 

Happy treating, it is worth it, and afterwards it is weird to have no worries. :D



__________________

Genotype: 3b

VL.�over 15, 000 000

Failed TX 2014: Interferon/Riba.

Cured using Sof/Dak combination.

I can eat cake again! <3 



Guru

Status: Offline
Posts: 744
Date:
Permalink  
 

I'm still in a state of shock, just got off the phone with Heath Net. The Dr. and I have appealed their denial of Harvoni for the third time, I think it is. Is that truly going to be the charm? I have been so pissed at Health Net for all the snafus in payments and other garbage which I wont go into now, but  They said my appeal has been APPROVED!!   WHAAAAAAAAaaaaaa Are you sure? was all I could say. I asked her over and over if this is really true. I couldn't contain my self. I'm a blubbering mess. She will be calling back with the confirmation number and I can call the pharmacy. I still don't want to get my hope up too much, what if it's a mistake?

To top this all off I'm going on vacation in 3 days, will be gone a half a month. Now I'm worried they will take it back because I cannot start right now. She said it shouldn't be a problem but I really tend to worry about things. 

PINCH ME! I'm not sure if this is really going to happen

Wow, Iris



__________________

in the silence of the woods, you will not be alone- Chief Seattle

58 years on planet, Female, diagnosed 1976 as non a non b, VL 3mill+, Fibro f-1f-2, Genotype 1a, treatment naive 

Page 1 of 1  sorted by
 
Quick Reply

Please log in to post quick replies.

Legal Disclaimer:

THIS FORUM, IT'S OWNERS, ADMINISTRATORS, MODERATORS AND MEMBERS DO NOT AT ANY TIME GIVE MEDICAL ADVICE AND IN ALL CASES REFER ANYONE HERE TO SEEK APPROPRIATE MEDICAL ADVICE FROM THEIR DOCTOR.