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insurance denied
Is anyone else battling their insurance company for treatment??
Sometimes it depends on the state you live in. In Michigan "the powers that be" decided to just let HEP C people die. Salvaldi was approved by the Feds in 2012 and last winter it was finally "approved" by the 11 people that decide life and death for the entire state. However, it is still not FUNDED so the "approval" meant next to nothing. I had to have my siblings and business partner pay for "high end" health insurance as I am broke and it costs $700 a month. We found an insurance company that still had Salvaldi and Daklinza on their formulary. It took me 14 months after diagnosis to get this as the state kept "playing" with my life and saying "it will get approved soon"-all LIES! You must get a support system and be extremely proactive if you are on Medicaid or other insurance that expects everyone to use the "old" treatment which is not even a positive cure.
Yes!! I was denied last year for Harvoni and we are trying again now and apparently if I get 2 written denials I might be eligible for Zepatier. They said I wasn't sick enough, it's so frustrating! It's all a numbers game.
Also they told me that my doc and I had to do the appeal process. There woould be No involvement from support path
I was informed support path will only pay for the meds if you don't have insurance or your insurance doesn't cover ANY HCV meds. Even If your insurance company covers the old school meds support path will not help. Getting help from them is out of the question for me. My insurance covers all the meds but only if your "sick enough" . I have appealed harvoni and the viekiera Pak..I expect it to be denied again. I will appeal again and again I guess..
Well they have support path and provide copay assistance and have 24 hour nurses for questions. They will also help with the appeal process.
What was discontinued was paying for the meds if denied by your medical insurance they discontinued that if I recall about June 2015
What was discontinued was paying for the meds if denied by your medical insurance they discontinued that if I recall about June 2015
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"discontinued was paying for the meds if denied by your medical insurance they discontinued that if I recall about June 2015"
Exactly!! I just found out yesterday. My doctor had my Gilead paperwork for well over a year. A doctor who knows their patient is going to be denied, over and over again should think outside of the box. Meaning he could have sent that paperwork in after the first denial. Patients are dying to get on meds and some of these doctors are more concerned with following policy. Arghhh! That's all I'm sayin'.
Exactly!! I just found out yesterday. My doctor had my Gilead paperwork for well over a year. A doctor who knows their patient is going to be denied, over and over again should think outside of the box. Meaning he could have sent that paperwork in after the first denial. Patients are dying to get on meds and some of these doctors are more concerned with following policy. Arghhh! That's all I'm sayin'.
Actually I was denied as well from Blue Shield, not sick enough. My doctor told me that after I go through all the denials and appeals, then he will go to bat for me through Gilead's support path program and get me the Harvoni for free or a small copay. I've been putting up with this crap for well over a year. My problem became extremely complicated because when I first started requesting tx from Blue Shield I had my own insurance card. My wife retired and I got on her insurance, same one Blue Shield, I didn't think it would create such a mess but it did.
What they did, like idiots is this. I had to get denials and appeals twice for two separate insurance cards which didn't make any kind of sense because I only have one card and one coverage and the two insurance cards are for the same person, me!!!!!!!!!!!!! Arghhh! Ridiculous!! It's not easy folks, just hang in there. It ***** because we're all basically dying to get on Harvoni literally and many doctors and insurance companies don't give a Shlt. That's a shame! good luck, fellow heppers!! Hey babyblue, you may want to ask your doctor to help you get Harvoni or whatever else you're trying to get for free as most drug companies have assistance programs. good luck!!
What they did, like idiots is this. I had to get denials and appeals twice for two separate insurance cards which didn't make any kind of sense because I only have one card and one coverage and the two insurance cards are for the same person, me!!!!!!!!!!!!! Arghhh! Ridiculous!! It's not easy folks, just hang in there. It ***** because we're all basically dying to get on Harvoni literally and many doctors and insurance companies don't give a Shlt. That's a shame! good luck, fellow heppers!! Hey babyblue, you may want to ask your doctor to help you get Harvoni or whatever else you're trying to get for free as most drug companies have assistance programs. good luck!!
1 Comments
SOB! Just found out Gilead doesn't have their support path anymore, just discounted copays. WTF! I swear that doctor I have ***** donkey kong!
Best I can tell you is appeal, appeal, appeal and then request an independent review from your insurance company it is your right under the affordable care act
Good luck
Good luck
I'll have to remember that. Thank you! They all say I'm not sick enough its so frustrating
Many of us have had this problem
Appeal to your insurance ask your doctor for assistance with your appeal. If they won't help get a different doctor who will.
Once you have appealed and been denied at least 3 times you can appeal through your state insurance commissioner.
Good luck
Lynn
Appeal to your insurance ask your doctor for assistance with your appeal. If they won't help get a different doctor who will.
Once you have appealed and been denied at least 3 times you can appeal through your state insurance commissioner.
Good luck
Lynn
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