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Hep C Discussion Forum -> On Treatment -> Does insurance cover all expenses of treatment with Sovaldi in Canada?
Post Info TOPIC: Does insurance cover all expenses of treatment with Sovaldi in Canada?
FIRE


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RE: Does insurance cover all expenses of treatment with Sovaldi in Canada?
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Thank you, Isiscat2011 and Gracie for sharing  your experience. Hopefully, will get more useful tips from other members.

Btw, is there any other internet forums where i could write?



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Isiscat2011


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Very interesting, Gracie.  I thought Canada's healthcare system was much different than that of the US but it sounds quite a bit like the US before the Affordable Health Care Act.  A mix of both private insurance and gvmt paid.  It sounds like the drug approval process is slower in Canada, however.

Under the ACA policy limits and denials for pre-existing conditions are no longer allowed so that is different than what you described for Canada.  Also, lower income people who couldn't get gvmt assistance with healthcare now are able to.  

I had tx before the ACA took effect.  Like you, I had coverage under 2 private policies during tx, but still ended up having to pay 10K just for the "specialty" drugs (5K prescription deductible for 2 years because I started tx in November and it continued into January).  The ACA has also eliminated separate prescription deductibles.  The maximum deductible now allowed for everything is around 6K.   Lifetime maximums have been banned under the ACA too so people needing transplants or multiple HCV tx won't run into the annual or lifetime barriers.    

Many people have the impression that everyone is covered for healthcare in Canada--I did anyway--but apparently that is not the case. 

  



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Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
Gracie


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Hi,

I am covered under two insurance plans. My own which has a 50 thousand dollar limit, and my husbands which is unlimited. Now that they are not recommending incevik any longer, most insurance companies would cover Sovaldi RIBA Inteferon treatments. The Solvaldi / Olysio is off label and very expensive so would be hard to get covered for unless you couldn't tolerate Inteferon. Unfortunately, every insurance company has it's own list of what is covered and what isn't. We also have provincial Medicare coverage which would pay for the treatments for those with low incomes and no private insurance. As of my last visit to my doctor in March, it wasn't approved for a treatment in our province yet. Other provinces are ahead of us though, so I would definitely check with the province you are planning on living in. I'd contact the Department of Health in that province to inquire. Wish I could tell you more, but I'm kind of in the dark about it as well. Things are changing so quickly, it's amazing really what we have coming up the pipeline. It's just hard waiting it out until it's all available.



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  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
FIRE


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Dear Gracie,

Could you please provide with more information about cost of treatment with Sovaldi in Canada?
thanks



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FIRE


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Hi Isiscat2011,

Thank you for your reply. I am not sure what kind of US visa i can get right now, probably only short term (few months). Therefore, i think i better focus only on Canadian Health Care system or to some developing countries where they have a deal with Sovaldi such as India and Egypt, but i couldn't find any proper source of information on internet in these countries.

thanks

 



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Isiscat2011


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  Hi again Fire:

I haven't looked into this, and I don't know your specific situation, but I'm wondering if you could get US coverage somehow?  You don't have to be a US citizen to get coverage; there is also something called "visitor's coverage."  If you could qualify for US coverage it would certainly be less expensive than paying cash for tx.

The only issue I see, assuming you could get US coverage, is that we in the US are not even sure yet what each insurance company's policy will be regarding who gets treated and when and this could also depend on how hard the individual doc is willing to push it.  It could be a crap shoot here for a while for many people. 

Let me know if you need any help researching the US stuff.  I know it can be difficult to try to figure out what is going on in a country in which you don't reside. 

 



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Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
Gracie


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Not covered in New Brunswick Medicare as of today. Private insurance coverage is the only way to get it, and it depends on which insurance coverage your on. Problem is, you will have a hard time qualifying for private insurance with hep c. 



__________________
  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
Isiscat2011


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FIRE wrote:

So, i am wondering, do you know whether  insurance covers all expenses related with Hep C treatment in Canada or US for foreigners who has no status. Obviously, i am not able to pay off the bill over 30k  USD. 

Welcome FIRE:

This looks like a good resource for Canada HCV information:  http://www.catie.ca/en/treatment/canadian-drug-programs#provincialterritorial  

Unfortunately, it is not 30K USD, it is more like 150K USD for tx combo drugs.  We have a few Canadians who stop in sometimes so hopefully they can give you a first hand account of what is happening in Canada.  Best regards. 



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Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
FIRE


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Hello Everybody,

Recently, i was diagnosed Hep C 1b, and where i live (Central Asia) there is no opportunity to take Sovaldi medicine. It is only possible to purchase Interferon and ribavirin which is not option for me now.

I have opportunity to move to Canada with 2 year VISA and live in my brother house and get treatment there. So, i am wondering, do you know whether  insurance covers all expenses related with Hep C treatment in Canada or US for foreigners who has no status. Obviously, i am not able to pay off the bill over 30k  USD.

Also, do you think it worth to consider to get treatment in Egypt or India?

Any comment is appreciated, thank you!

Alo

 



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