Yes, absolutely give them a call. They can tell you a lot regarding what they will be able to do. Often, even if you don't currently qualify, they will tell you what's required to qualify. Sometimes it's a financial limit, sometimes how your current insurance and possible copays apply, I could go on and on. It varies with everyone.
Many times your fibrosis stage applies. Since you haven't had a recent determination, they may be able to make some recommendations on what you can do to get that accomplished. You may have increased fibrosis after 20 years and that should be determined. If you are F3 or above, you may qualify. Better to give them a call and start the process. Your doctor will need to get involved (documentation, orders for treatment, etc). They are usually familiar with that.
Momentum should be able to explain how your insurance plans will play into it. The doctors, insurance and pharmacies all work together. Gilead will be better able to explain how that works. So start putting together all the information you have and jot down what you can remember before calling. Names, dates, doctors, any lab tests you have, will help when talking to them. They will probably have a link to their online application. Be sure to ask for their direct fax number so you can send documentation when required. Their representatives are usually very knowledgeable and helpful. Good luck...
Think and stay positive!
Gracie said
Apr 18, 2015
Thanks Tig,
From the monograph I posted (second photo), it looks like I have to be f2 or higher. The other 3 are a given, this is the one I have no proof of. I must be that by now. I had a biopsy about 20 years ago and was stage 1 then. I also have private insurance, two in fact. So this seems hopeful at least. I sure hope they cover it. There are no fibroscan machines where I'm from, that's for sure.
So this company that you posted will deal with my insurance companies for me? Maybe I should give them a call and press for information before I go see the doc. I want to be well armed when I go and see her.
Tig said
Apr 18, 2015
Hi Gracie,
Those two pages appear to be part of the Harvoni Monograph. It's got enough info to give you a headache! But it certainly spells everything out.
I can't say how the Momentum program decides eligibility in Canada, you are our first attempting to qualify there. The U.S. support Path bases eligibility on several factors. Income, lack of or less than adequate insurance, fibrosis and other health issues and provider cancellation during tx are just a few. Seems everyone's circumstances are unique in some way. Getting started with the process explains what you need to qualify.
Heres some information on the Momentum program if you don't already have it. The link to the article is included. Hope this helps.
(Sorry we missed your earlier post)
Patient Assistance Program in Canada
To assist eligible hepatitis C patients in Canada with access to Harvoni, Gilead Sciences Canada, Inc. has added the medicine to the Gilead Momentum Support Program, which provides an integrated offering of support services for patients and healthcare providers. The program provides access to dedicated case managers to help patients and their providers with insurance-related needs, including identifying their coverage options through either private insurance or publicly funded programs. In addition, the program provides financial assistance for eligible patients who need help paying for out-of-pocket medication costs.
For more information regarding the Momentum Program in Canada, please call 1-855-447-7977.
I am finally going to get to see a doctor regarding my treatment options. My old gastro stopped treating people as his hep nurse went on maternity leave. Here in Canada that is one year. I'm going to see a new one and want to press for harvoni.
Are there any Canadians out there on Harvoni?
Is it hard to get insurance to cover it?
Any suggestions on what to say to her to help the approval process? Do they treat those with more symptoms even if there is no evidence of cirrosis?
Cautiously optimistic that I can get it, but want to go armed with as much as I can to help.
Hi Gracie,
Yes, absolutely give them a call. They can tell you a lot regarding what they will be able to do. Often, even if you don't currently qualify, they will tell you what's required to qualify. Sometimes it's a financial limit, sometimes how your current insurance and possible copays apply, I could go on and on. It varies with everyone.
Many times your fibrosis stage applies. Since you haven't had a recent determination, they may be able to make some recommendations on what you can do to get that accomplished. You may have increased fibrosis after 20 years and that should be determined. If you are F3 or above, you may qualify. Better to give them a call and start the process. Your doctor will need to get involved (documentation, orders for treatment, etc). They are usually familiar with that.
Momentum should be able to explain how your insurance plans will play into it. The doctors, insurance and pharmacies all work together. Gilead will be better able to explain how that works. So start putting together all the information you have and jot down what you can remember before calling. Names, dates, doctors, any lab tests you have, will help when talking to them. They will probably have a link to their online application. Be sure to ask for their direct fax number so you can send documentation when required. Their representatives are usually very knowledgeable and helpful. Good luck...
Think and stay positive!
Thanks Tig,
From the monograph I posted (second photo), it looks like I have to be f2 or higher. The other 3 are a given, this is the one I have no proof of. I must be that by now. I had a biopsy about 20 years ago and was stage 1 then. I also have private insurance, two in fact. So this seems hopeful at least. I sure hope they cover it. There are no fibroscan machines where I'm from, that's for sure.
So this company that you posted will deal with my insurance companies for me? Maybe I should give them a call and press for information before I go see the doc. I want to be well armed when I go and see her.
Hi Gracie,
Those two pages appear to be part of the Harvoni Monograph. It's got enough info to give you a headache! But it certainly spells everything out.
I can't say how the Momentum program decides eligibility in Canada, you are our first attempting to qualify there. The U.S. support Path bases eligibility on several factors. Income, lack of or less than adequate insurance, fibrosis and other health issues and provider cancellation during tx are just a few. Seems everyone's circumstances are unique in some way. Getting started with the process explains what you need to qualify.
Heres some information on the Momentum program if you don't already have it. The link to the article is included. Hope this helps.
(Sorry we missed your earlier post)
Patient Assistance Program in Canada
To assist eligible hepatitis C patients in Canada with access to Harvoni, Gilead Sciences Canada, Inc. has added the medicine to the Gilead Momentum Support Program, which provides an integrated offering of support services for patients and healthcare providers. The program provides access to dedicated case managers to help patients and their providers with insurance-related needs, including identifying their coverage options through either private insurance or publicly funded programs. In addition, the program provides financial assistance for eligible patients who need help paying for out-of-pocket medication costs.
For more information regarding the Momentum Program in Canada, please call 1-855-447-7977.
http://www.gilead.com/news/press-releases/2014/10/health-canada-issues-notice-of-compliance-for-gileads-harvoni-ledipasvirsofosbuvir-the-first-oncedaily-single-tablet-regimen-for-the-treatment-of-genotype-1-chronic-hepatitis-c
Page 2
I found some information ...
I am finally going to get to see a doctor regarding my treatment options. My old gastro stopped treating people as his hep nurse went on maternity leave. Here in Canada that is one year. I'm going to see a new one and want to press for harvoni.
Are there any Canadians out there on Harvoni?
Is it hard to get insurance to cover it?
Any suggestions on what to say to her to help the approval process? Do they treat those with more symptoms even if there is no evidence of cirrosis?
Cautiously optimistic that I can get it, but want to go armed with as much as I can to help.
Thanks peeps!