Aa
Getting assistance with Sovaldi on Medicare, Medicaid, etc.
Good news!
For those on Medicare, Medicaid, etc., you CAN get assistance with Gilead's Sovaldi from the Patient Access Network (PAN).
https://www.panfoundation.org/
The specific application is found here:
https://www.panfoundation.org/fundingapplication/index.php?8
Their phone number is 866-316-PANF. You can also apply by phone.
Yay!! Merry Christmas!
HepCat
...
For those on Medicare, Medicaid, etc., you CAN get assistance with Gilead's Sovaldi from the Patient Access Network (PAN).
https://www.panfoundation.org/
The specific application is found here:
https://www.panfoundation.org/fundingapplication/index.php?8
Their phone number is 866-316-PANF. You can also apply by phone.
Yay!! Merry Christmas!
HepCat
...
I need help, I do not know how, I do not who to contact. can me send some paipers please.i am not to good in computers
I need help for having cure for my hepatitis c.i am with this doctor but he never did any thing. please help
Wonder if Gilead Sciences hired anyone yet?
Rebates Sr. Manager/Manager
Gilead Sciences - San Francisco Bay Area- Posted 11 days ago
Job description
• Manage a team of department analysts to ensure that accurate pricing and/or discounts are extended to eligible entities under the government programs in which Gilead participates, including but not limited to: Public Health Services, Aids Drug Assistance Program, Medicaid, Medicaid Supplemental Rebates, Managed Medicaid, Tricare, Veterans Affairs, State Pharmacy Assistance Programs, etc.
http://www.linkedin.com/jobs2/view/10368107
Rebates Sr. Manager/Manager
Gilead Sciences - San Francisco Bay Area- Posted 11 days ago
Job description
• Manage a team of department analysts to ensure that accurate pricing and/or discounts are extended to eligible entities under the government programs in which Gilead participates, including but not limited to: Public Health Services, Aids Drug Assistance Program, Medicaid, Medicaid Supplemental Rebates, Managed Medicaid, Tricare, Veterans Affairs, State Pharmacy Assistance Programs, etc.
http://www.linkedin.com/jobs2/view/10368107
I don't know if i missed that but this mentions folks with no insurance...
http://www.mysupportpath.com/
http://www.mysupportpath.com/
Vermont
"Also not part of the estimate is an $89 million shortfall in the state’s Medicaid fund spread out over the next three years, which Klein said the state will need to address regardless of the transition to Green Mountain Care."
http://vtdigger.org/2014/02/06/states-share-universal-health-care-2-billion-give-take/
"Also not part of the estimate is an $89 million shortfall in the state’s Medicaid fund spread out over the next three years, which Klein said the state will need to address regardless of the transition to Green Mountain Care."
http://vtdigger.org/2014/02/06/states-share-universal-health-care-2-billion-give-take/
let me try this again...finger hit the submit button by mistake.
Hi Jimmy,
I think you are right in most if not all of your opinions. I believe I was approved because it was very early and VT medicaid had not developed a policy yet. I was initially denied but they reconsidered. I'm probably the only individual that was approved by VT medicaid according to my doctor. I am in the care of the hepatology department at Dartmouth Hitchcock medical center in New Hampshire which is a large teaching hospital. They told me that nobody is approving now. Not VT medicaid, not NH medicaid, not private insurance. They have a total of 8 individuals on treatment out of probably dozens if not more that would be on treatment if the denials were not happening.
I am genotype 2 F2-3 I probably could have waited but who knew all this would be going on? When my prescription was written on January 6 the doctors office told me there would be no problem and everyone should be on the meds within a a week or two. It didn't work out that way.
I'm very luck because I almost didn't get the prescription on January 6. There was an ice storm that day. I am 1.5 hours from the hospital. I got stuck in a backup due to an accident and was running an hour late. I called the office and they said to turn around they would re-schedule for Jan 23. I said I was coming anyway and would wait for a cancellation. They said don't bother it won't happen. I indeed went anyway and sure enough got in to see the doc. Then the nurse practitioner listened to my heart and said I was missing a beat. I was sent to cardiology. I had an ekg. The ekg came back with an abnormal result and they told me I had had a heart attack at some point and that I couldn't start treatment because of the risk from anemia. I went back the next day, Jan 7 and had an echocardiogram. The result was normal! No problems at all, no prior heart attack, nothing. The prescription for Sovadi/Ribavirin was written that day. I started treatment on Jan 28.
If I had not persisted and made the appointment on Jan 6 I would now be in the group that was denied.
Hi Jimmy,
I think you are right in most if not all of your opinions. I believe I was approved because it was very early and VT medicaid had not developed a policy yet. I was initially denied but they reconsidered. I'm probably the only individual that was approved by VT medicaid according to my doctor. I am in the care of the hepatology department at Dartmouth Hitchcock medical center in New Hampshire which is a large teaching hospital. They told me that nobody is approving now. Not VT medicaid, not NH medicaid, not private insurance. They have a total of 8 individuals on treatment out of probably dozens if not more that would be on treatment if the denials were not happening.
I am genotype 2 F2-3 I probably could have waited but who knew all this would be going on? When my prescription was written on January 6 the doctors office told me there would be no problem and everyone should be on the meds within a a week or two. It didn't work out that way.
I'm very luck because I almost didn't get the prescription on January 6. There was an ice storm that day. I am 1.5 hours from the hospital. I got stuck in a backup due to an accident and was running an hour late. I called the office and they said to turn around they would re-schedule for Jan 23. I said I was coming anyway and would wait for a cancellation. They said don't bother it won't happen. I indeed went anyway and sure enough got in to see the doc. Then the nurse practitioner listened to my heart and said I was missing a beat. I was sent to cardiology. I had an ekg. The ekg came back with an abnormal result and they told me I had had a heart attack at some point and that I couldn't start treatment because of the risk from anemia. I went back the next day, Jan 7 and had an echocardiogram. The result was normal! No problems at all, no prior heart attack, nothing. The prescription for Sovadi/Ribavirin was written that day. I started treatment on Jan 28.
If I had not persisted and made the appointment on Jan 6 I would now be in the group that was denied.
Hi Jimmy,
I think you are right in most if not all of your opinions. I think I was approve
I think you are right in most if not all of your opinions. I think I was approve
Noticed your comment other topic "right after I was approved for Sovaldi Vermont Medicaid stopped approving and is now denying for at least 6 months"
MY OPINION
Many insurance companies, medical providers, governmental agencies, pharmacies and patients are "freaking out"
1. The affordable care act care has added over 3 million newly insured. The result is a big backlog for patients get a covered medical provider. this is resulting in a communication overload between medical providers, insurance companies, pharmacies and patients..
2. Some members here were able to get quick approval either from their insurance company, gov care or even the drug companies. Some may have done this to be able the companies could quote that they are providing care asap but now have to adjust to properly provide coverage to the most urgent patients now. Others haven't acted yet because of bureaucracy, cost or other.
3, There are a lot of unknowns like how fast can the medicine be produced and made available to demand and who really needs it now. Those who treatment is not urgent or absolutely necessary to start within the next 3 to 6 months unless lucky will probably have to wait longer. It would really suck if those with urgent need, who can be treated, can't get tx real soon.
.
4. I am sure there are other reasons
I am F3/F4 last July Geno 2 very well compensated but probably F4 now. Was told by VA that may have to wait at least 60 to 90 days but maybe longer. They are only treating compassionate care patients now with Sovaldi. Can except the current situation and have no problem waiting for a little while. If after another 6 months or if my condition worsens then I may proceed with a more active pursuit of treatment (legally of course).
more info about my conditions,,tests and etc are in my journal and replies
MY OPINION
Many insurance companies, medical providers, governmental agencies, pharmacies and patients are "freaking out"
1. The affordable care act care has added over 3 million newly insured. The result is a big backlog for patients get a covered medical provider. this is resulting in a communication overload between medical providers, insurance companies, pharmacies and patients..
2. Some members here were able to get quick approval either from their insurance company, gov care or even the drug companies. Some may have done this to be able the companies could quote that they are providing care asap but now have to adjust to properly provide coverage to the most urgent patients now. Others haven't acted yet because of bureaucracy, cost or other.
3, There are a lot of unknowns like how fast can the medicine be produced and made available to demand and who really needs it now. Those who treatment is not urgent or absolutely necessary to start within the next 3 to 6 months unless lucky will probably have to wait longer. It would really suck if those with urgent need, who can be treated, can't get tx real soon.
.
4. I am sure there are other reasons
I am F3/F4 last July Geno 2 very well compensated but probably F4 now. Was told by VA that may have to wait at least 60 to 90 days but maybe longer. They are only treating compassionate care patients now with Sovaldi. Can except the current situation and have no problem waiting for a little while. If after another 6 months or if my condition worsens then I may proceed with a more active pursuit of treatment (legally of course).
more info about my conditions,,tests and etc are in my journal and replies
Dear Gilead,
If Medicaid doesn't pay for my wife's Sovaldi, and you don't either because you're greedy and mean, I'm going to make your company the Laughingstock of the Internet. You've been warned.
by
-Alex Weinstein, Clarksburg WVa.
If Medicaid doesn't pay for my wife's Sovaldi, and you don't either because you're greedy and mean, I'm going to make your company the Laughingstock of the Internet. You've been warned.
by
-Alex Weinstein, Clarksburg WVa.
I missed that one too. I knew about medicaid expansion funding but didn't put two and two together...
Yes it was staring me in the face You live in one of the states with Medicaid expansion. klonny55 was just able to get Medicaid because of the expanded coverage. I don't know if that applies to you or you were already qualified. WV has had a high number of new enrolls because of the expansion. Overall their cost will be lower even averaging in those already covered at lower income. WV is a poor state Fed percentage for basic Medicaid is higher and based on average per capita income.
The big plus factor for those getting coverage because of Medicaid expansion is that the US government will pay a 100% of the cost for the first 3 years. With these new drugs that are must better tolerated with high SVR rates, of course it make sense for them to quickly approve these treatments.
We all know the government, they promise to cover 100% then 90% for many years but then when a new financial crisis arises they cut back the amount they pay the states who have Medicaid expansion.
It's a big win for those patients that become SVR, the state gets the US to pay 100% and the future HCV related health cost of those that achieve SVR are greatly reduced.
Hopefully the pressure will build for more RED states to implement Medicaid expansion.
To ALL on Medicaid it depends on your state requirements, what is covered, who makes the determination etc. Just because some Medicaid members get coverage doesn't necessarily mean you will. After your doctor proscribes the treatment drugs then you will get your answer sooner or later depending on appeals & the drug company Not sure if some doctors in some states might under obvious or not pressure to hold off proscribing new treatment for some depending on their current HCV medical status.
The big plus factor for those getting coverage because of Medicaid expansion is that the US government will pay a 100% of the cost for the first 3 years. With these new drugs that are must better tolerated with high SVR rates, of course it make sense for them to quickly approve these treatments.
We all know the government, they promise to cover 100% then 90% for many years but then when a new financial crisis arises they cut back the amount they pay the states who have Medicaid expansion.
It's a big win for those patients that become SVR, the state gets the US to pay 100% and the future HCV related health cost of those that achieve SVR are greatly reduced.
Hopefully the pressure will build for more RED states to implement Medicaid expansion.
To ALL on Medicaid it depends on your state requirements, what is covered, who makes the determination etc. Just because some Medicaid members get coverage doesn't necessarily mean you will. After your doctor proscribes the treatment drugs then you will get your answer sooner or later depending on appeals & the drug company Not sure if some doctors in some states might under obvious or not pressure to hold off proscribing new treatment for some depending on their current HCV medical status.
Gilead will cover it as long your doctor prescribes it and the denial/appeal process goes the way I described above.
Jimmy,
Lol. What state am I in?
What's my username? ;0)
Thanks for the helpful info.
Lol. What state am I in?
What's my username? ;0)
Thanks for the helpful info.
I certainly hope that is the case. We haven't even gotten my wife's viral counts back yet. I am concerned that she is only in the acute stage right now. Do you think Gilead will provide free meds to someone who isn't critical? I can't imagine having to tell me wife "you have to wait until you get sicker."
-Alex
-Alex
I am in Connecticut. I was told by the pharmacy that people with medicaid were being approved within an hour, however people with private insurance are being denied and are stuck going through appeals. I was so shocked when medicaid approved $150,000 of off-label tx.
Great to see another member covered for off label treatment by Medicaid.
BTW what state do you live in?
Most states have managed care, Medicaid recipients are enrolled in a private health plan. Core eligibility groups of poor children and parents are most likely to be enrolled in managed care. While the aged and disabled eligibility groups more often remain in traditional "fee for service" Medicaid. It varies so much from state to state
BTW what state do you live in?
Most states have managed care, Medicaid recipients are enrolled in a private health plan. Core eligibility groups of poor children and parents are most likely to be enrolled in managed care. While the aged and disabled eligibility groups more often remain in traditional "fee for service" Medicaid. It varies so much from state to state
I am on medicaid and I am approved for Sovaldi/Olysio with $0 out of pocket costs. Previous partial responder 3x interferon/ribavirin though, treatment naive requires interferon with sovaldi and riba.
That's great that you got coverage and low co-pay. Vermont is one of the best states for coverage.
WVPatient What state are you in? it can be different for each state and each persons medical condition. The only way you will find your answer is for your wife's doctor to do what klonny55 and I mentioned.
I wish you the best.
http://www.webmd.com/health-insurance/medicaid-health-care-people-low-incomes
"Although the federal government sets up general guidelines, each state runs its own Medicaid program. States establish what health care services are covered and which groups of people get coverage. As a result, Medicaid programs vary a great deal from state to state."
Where the states stand on Medicaid expansion
25 states, D.C. expanding Medicaid
12:44 PM - February 7, 2014
http://www.advisory.com/daily-briefing/resources/primers/medicaidmap
WVPatient What state are you in? it can be different for each state and each persons medical condition. The only way you will find your answer is for your wife's doctor to do what klonny55 and I mentioned.
I wish you the best.
http://www.webmd.com/health-insurance/medicaid-health-care-people-low-incomes
"Although the federal government sets up general guidelines, each state runs its own Medicaid program. States establish what health care services are covered and which groups of people get coverage. As a result, Medicaid programs vary a great deal from state to state."
Where the states stand on Medicaid expansion
25 states, D.C. expanding Medicaid
12:44 PM - February 7, 2014
http://www.advisory.com/daily-briefing/resources/primers/medicaidmap
I should add that the process goes like this: Your doctor prescribes the meds and sends the prior authorization application to Medicaid. They either approve or deny. If they deny there is an appeal. If the appeal fails then Gilead steps in with the free meds.
Hi Alex,
I am in Vermont, genotype 2, 11 days into 12 weeks of Sovaldi/Ribavirin. I am recently enrolled as of Jan 1, 2014 into Vt's medicaid expansion program. Medicaid approved my prescription after initially denying it. We didn't go through an appeal exactly, more an informal reconsideration. My doctor totally went to bat for me and evidently was convincing. My copay is $6 a month. I was in touch with Gilead during this process and they assured me that they would provide the meds for no charge if Medicaid ended up denying an appeal. In order to receive free meds from Gilead you need to make less than 500% of the federal poverty level income. That's $77,500 household income for a family of two. They count the income of everyone under the same roof and all of their income. The $77,500 number goes higher if there are more than two people living under the same roof, but they also count any additional income. Medicaid also uses household income to determine eligibility. Anyone who qualifies for Medicaid would certainly qualify for Gilead's assistance. I hope this makes sense! Best, Dave
I am in Vermont, genotype 2, 11 days into 12 weeks of Sovaldi/Ribavirin. I am recently enrolled as of Jan 1, 2014 into Vt's medicaid expansion program. Medicaid approved my prescription after initially denying it. We didn't go through an appeal exactly, more an informal reconsideration. My doctor totally went to bat for me and evidently was convincing. My copay is $6 a month. I was in touch with Gilead during this process and they assured me that they would provide the meds for no charge if Medicaid ended up denying an appeal. In order to receive free meds from Gilead you need to make less than 500% of the federal poverty level income. That's $77,500 household income for a family of two. They count the income of everyone under the same roof and all of their income. The $77,500 number goes higher if there are more than two people living under the same roof, but they also count any additional income. Medicaid also uses household income to determine eligibility. Anyone who qualifies for Medicaid would certainly qualify for Gilead's assistance. I hope this makes sense! Best, Dave
No one is telling you that she will be able to get treatment, basically for free? I can not answer that question.
Your wife's doctor's will have to recommend treatment and submit to her Medicaid plan to see if they will cover it. If not your doctor and you will have to file and/or appeal. If they will cover then you will be told what your co-pay will be.
Then if you can't pay that you would then apply here
Patient Access Network (PAN).
The specific application is found here:
https://www.panfoundation.org/fundingapplication/index.php?8
If Medicaid coverage is denied and the appeal is denied and your doctor felt that treatment was needed to be started soon then you and he could try to directly get the drug companies to provide it free. Financial documentation will be needed.
You haven't mentioned anything about her HCV condition, genotype fibrous status blood test symptoms etc. My guess is that if her condition is good with no (or low) fibrous or other complications she may have to wait a couple years for the new treatments to be covered by Medicaid. Some better private plans are already covering the new treatments.
I am genotype 2a,2c F3 and my VA doctor just told.me that I can probably start Riba and Sovaldi for 12 weeks within the next month or so.
The VA negotiated a price of about $650 per pill (unofficial) My copay will be either $0 or $18 a month (I am still calculating my low income for last year )
Good luck
Your wife's doctor's will have to recommend treatment and submit to her Medicaid plan to see if they will cover it. If not your doctor and you will have to file and/or appeal. If they will cover then you will be told what your co-pay will be.
Then if you can't pay that you would then apply here
Patient Access Network (PAN).
The specific application is found here:
https://www.panfoundation.org/fundingapplication/index.php?8
If Medicaid coverage is denied and the appeal is denied and your doctor felt that treatment was needed to be started soon then you and he could try to directly get the drug companies to provide it free. Financial documentation will be needed.
You haven't mentioned anything about her HCV condition, genotype fibrous status blood test symptoms etc. My guess is that if her condition is good with no (or low) fibrous or other complications she may have to wait a couple years for the new treatments to be covered by Medicaid. Some better private plans are already covering the new treatments.
I am genotype 2a,2c F3 and my VA doctor just told.me that I can probably start Riba and Sovaldi for 12 weeks within the next month or so.
The VA negotiated a price of about $650 per pill (unofficial) My copay will be either $0 or $18 a month (I am still calculating my low income for last year )
Good luck
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
