New at this. Idea about monthly cost

[cb867]

I start treatment June 26. My doctor said most insurance covers the treatment. I have bluecross blueshield. Any ideas on how much I will be paying? Thanks

[Kathy73]

I have Connecticare but I pay $55/month for Pegasys and Ribavirin (combined) through Curascript. Of course any side effects that need medication will cost you more. Also doctor's visits.

[GreatBird]

You have to contact your insurance company and ask them or look in any booklets they provided you. It depends on their prescription co-pay, labs co-pay, etc.

[hepcD]

i had blue cross blue shield ppo with caremarks providing the ribavirin and interferon. My cost per month was 10.00   5 dollars for interferon and 5 dollars for ribaviran. Makes me want to sing a song 5 dollar 5 dollar interferon LOL

[Kathy73]

Wow, I like your co-pay better than mine. Was this recent?

[hepcD]

I am 2 yrs post tx . So it was 3 yrs ago.  i was blown away when i got my first bill for 3 month supply was 30.00.  My drug plan with caremarks is awesome. I feel really bad for the people out their that end up paying major money for the tx. I wish we had a universal health care plan like the rest of the world.

[Kathy73]

I feel the same way. While I am happy that I can afford tx with my health insurance, I can't help but sympathize with others who have to go on trials or worse, not treat. It is amazing that we think the US is so special/superior and yet so many of its citizens aren't treating as special at all.

[Marc1955]

I strongly encourage you to get a clear answer to this question before you begin. You can't take anyone else's experience as something to go on. Everyone's health plan is different. Your doctor may be the exception, but the vast majority don't have a clue about insurance issues. Indeed, your doc's comment that "most insurance covers the treatment" is par for the course for a doc (and not at all helpful).

You will probably not be able to get the information by reading the written information supplied with your plan. These normally do not go into that level of detail. You'll want to call the insurance  company directly and ask them whether the specific medications are covered. When you do, make sure you have the precise names of the medications your doctor wants to prescribe. Some insurance companies have outdated formularies and will cover one version of a medication and not another. That can lead to a problem down the road. Sometimes there are big variations in their coverage of different versions of the same drug. If that's true in your case, you'll want to raise with your doctor, but it's something to do before you start treatment, rather than once you've begun.

Be aware that you may not get a reliable answer from the insurance company. I don't want to shock you, but health insurance companies are not designed to help you with your treatment – at least not willingly. They are designed to frustrate you as much as possible in the hopes that you will give up and go away.

A very good source of getting a clear answer as to whether your treatment will be covered is your pharmacist. Usually, with a program such as combination therapy, you will be using a speciality pharmacy. I use Pharmacare, which is now owned by CVS. (Your insurance may steer you to a company, but you are under no obligation to use the one they steer you to.)  One thing you'll want to do before starting treatment is to line up your pharmacy. I find a local pharmacy is better because they messenger my medications the same day I order, but this is up to you. The Interferon needs to be constantly refrigerated, so you want the kind of pharmacy that is familiar with special medications.

Normally a doctor works with a nurse practitioner who monitors HCV patients in treatment. If that is true in the case of your doc, ask the NP if there is a pharmacy he or she likes to use. Then, once you have identified the pharmacy, call them and ask them whether there are any issues getting the medications covered by your specific insurance plan. These pharmacies are on the front line, constantly fighting for patients to get their medications covered. They are very knowledgeable and can give you a solid understanding of what you'll be facing down the road with the coverage of your medication.

Gook luck! Sorry for the long post. But please, don't rely on your doctor's reassurances and check this all out in advance. You don't want to have an unpleasant surprise just as you're starting treatment. FYI, the over-the-counter cost of these two medications is roughly $4,000 per month.