Marketplace insurance

[Rebel202]

New to this forum....not to Hep C.  I have genotype 1A, diagnosed in 1993, but I have had this at least 25 years.  Trying to walk through the maze of insurance.  No treatment, other than Milk Thistle.  I am self employed, so the cost of insurance is on me.  Question I have is there one plan that is better, as far as prescription coverage?  My viral count has doubled in the last 18 months, so considering treatment.  The other factor, I am 64 and a smoker.

Thanks for any info/experience.

[AugustineMama]

Hey Rebel, I found that the biggest thing about getting these new drugs were how far these physicians would go to get it done. My docs are at a transplant center; Mayo; they sent in a request for Olysio and Solvaldi which were off-label at the time, Humana denied it, they sent in a letter the same day for an appeal, they overturned it and I had the meds in hand in one week from their specialty pharmacy in Rochester. I paid $100 for both drugs. Good luck to you. I might add they are worth fighting for as they have almost nil side effects and for the most part are very effective.

[dontworry_behappy1]

I don't know how old you are or where you live.  Plans are so different but if your looking for something that will cover all your needs... look at HMO coverage.  This is what I have.   What your insurance won't cover can be picked up by other means.   The drug companies offer help for those who insurance companies are lacking.   I found this website "HepC.com".  If you go to this website and to the mustered colored box on the left.   The very last entry is "support resources" gives a vast amount of services including financial assistance.   You might want to take a really close look at what is offered.  This site is sponsored by AbbVie.  The drug company looking to release the next wave of Hepatitis C treatment drugs.


Best to you

[Rebel202]

Thanks for your responses.  I have taken Milk Thistle for almost 30 years. I went through IU Med center in 1993, after the Hep C diagnosis.  I had a biopsy done in 95/96, that showed minimal scarring.  My count in 1993 was 2.3mil, in 2012 it was 2.6 mil and this year 2014 it jumped to 4.3 mil.  I have not seen the high dollar liver guy in over 15 years.  I was not interested in the treatments back when, as I was familiar with the dastardly interferon, through involvement with the AIDS task force.  I was questioning which, if any, of the insurance companies cover any of the new treatments.  I have read extensively the different plans on the Obamacare web-site,  It is like trying to understand nuclear physics with a third grade education.  I checked the Gilead website already, for help with the meds.  What are your experiences with your insurance plans?  I need to make a decision soon as to which plan to go with,  Thank for sharing.....

[Ekkiemom]

Hi Rebel... Welcome to the community......everyone has given you some good options to consider and you definitely need to treat. I am GT1a as well and am currently treating with Sovaldi/Ribavirin for 24 wks Stage 3-4 fibrosis. Have been UND since 21 days after SOT, 4 wks to go.  Just FYI as far as GT1a info is concerned.....
As posted above there are Patient Assist Programs to help with costs.
If you are going to treat with Gilead drugs (sovaldi/Harvoni) some people have qualified to just pay $5 a month for meds, some don't pay a thing.  Go to www.gileadsciences.com they can talk to you directly or have them mail info to you.
Good Luck to you and keep the faith. We are here for you
Peace
Deb

[Frank J. Perrotta]

As c-d-m has offered, don't think prescription coverage should be your concern as to treatment as there are many free options with the big pharmas. It seems that you must have a doc if you are getting your labs done...

Maybe other scripts, to help with tx, will be an issue - but big pharma will usually help there too.

I would post a new thread as I have not kept up with it all - not sure what is best at this time to say treat or not and with what: viral load? biopsy? etc...

There are so many knowledgeable people on this forum it is rather amazing so please take your time before rushing into something you may have years or decades to wait on... studies show that, and they were small studies, about 5% of HCVers became cirrhotic. While most doctors/institutions who recognize Post-Interferon Syndrome *The Mayo Clinic definition for long term side effects of Interferon of which I have been disabled from for about 9+ years, seems to be roughly the same of 5%. We have no idea what the new tx will bring with long term sides.

As far as finding insurance options - it should be pretty easy. This is the time of year Medicare is rushing to get people on secondary insurances and agents are all over the place. I am sure they will talk to you as well. I believe I have seen on the news that the "ObamaCare" people are suppose to be in shopping malls but have toll-free numbers. All the pharmacies like RiteAid are suppose to have agents available to help people with decisions... as well as independent insurance offices all over town where you can walk into to get advice.

Best of luck with your health & in this difficult decision,
frank

[can-do-man]

Welcome here. There's a few things you could do. First check and see if there is any clinical trials in your area by going to,

Clinicaltrials.gov and type in HCV and your area. Next thing is go to a doctor and explain you have no insurance and ask about getting the meds for free as there is plenty of ways to get this done.

Being your 64 you are just short of being able to get Medicare at 65. Wishing you the best.