I wonder if some of the call centers are US based? Regardless, I think it will be a while before all copies are updated to include the new protocols. Lets keep our fingers crossed that they do indeed add them to the formularies within the month. I'm glad you received confirmation that all regions have done so, that's a great bit of news!
Tig
Miss B said
Nov 2, 2014
I called Kaiser Member Services last week in California & was told that Harvoni is now on the Formulary in all regions. She said they update the online formulary once a month. It's hit or miss when you call Kaiser. The first person didn't know what the formulary is. She kept repeating "Forms? forms? You want forms?" Ugh
Here is a link for a Kaiser Prior Authorization form for Sovaldi/Olysio. I can't find one online for Harvoni. Maybe it will have similar guidelines for treatment. https://healthy.kaiserpermanente.org/static/health/en-us/pdfs/nw/nw_sovaldi_olysio.pdf
-- Edited by Miss B on Monday 3rd of November 2014 03:35:43 AM
-- Edited by Miss B on Monday 3rd of November 2014 03:36:14 AM
Tig said
Nov 2, 2014
Hey John,
I've been looking for information on the Kaiser offerings and this page is as close as I can get to finding out what's in store for you this coming year. You'll notice multiple formularies, HMO, Medicare and a Comprehensive model. Each offers more, some less, but I've discovered that most carriers will provide coverage of medications found on all formularies provided the applications are submitted properly, particularly during the appeals process. Why there are so many hoops to jump through is beyond me, but we're witnessing this across most carriers right now. I see Sovaldi is listed as an approved Anti Viral, but no addition of Harvoni on the written copy. That can be changed at any moment, so the best determination is to contact Member Services HERE
Thanks Miss B,
I wonder if some of the call centers are US based? Regardless, I think it will be a while before all copies are updated to include the new protocols. Lets keep our fingers crossed that they do indeed add them to the formularies within the month. I'm glad you received confirmation that all regions have done so, that's a great bit of news!
Tig
I called Kaiser Member Services last week in California & was told that Harvoni is now on the Formulary in all regions. She said they update the online formulary once a month. It's hit or miss when you call Kaiser. The first person didn't know what the formulary is. She kept repeating "Forms? forms? You want forms?" Ugh
Here is a link for a Kaiser Prior Authorization form for Sovaldi/Olysio. I can't find one online for Harvoni. Maybe it will have similar guidelines for treatment. https://healthy.kaiserpermanente.org/static/health/en-us/pdfs/nw/nw_sovaldi_olysio.pdf
-- Edited by Miss B on Monday 3rd of November 2014 03:35:43 AM
-- Edited by Miss B on Monday 3rd of November 2014 03:36:14 AM
Hey John,
I've been looking for information on the Kaiser offerings and this page is as close as I can get to finding out what's in store for you this coming year. You'll notice multiple formularies, HMO, Medicare and a Comprehensive model. Each offers more, some less, but I've discovered that most carriers will provide coverage of medications found on all formularies provided the applications are submitted properly, particularly during the appeals process. Why there are so many hoops to jump through is beyond me, but we're witnessing this across most carriers right now. I see Sovaldi is listed as an approved Anti Viral, but no addition of Harvoni on the written copy. That can be changed at any moment, so the best determination is to contact Member Services HERE
Kaiser Permanente 2015 Comprehensive Formulary
Tig
I have heard nothing yet!