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week 8 UND and fighting insurance company
The magic words came today - Not Detected - although Gilead did consider me UND at 4 weeks these actual words are now in my PCR. My doctor feels that although my ANC went from 670 to 840 between Monday and Friday, that we need to be prepared for Neupogen in the event that it drops again. The insurance company has denied coverage for this because HCV treatment is not on their inclusion list for medical conditions approved for neupogen usage. WTF? I know that a lot of members have had issues with their insurance companies but was wondering if anyone ran across this situation and if so, how they dealt with it. At $4400 per month, no way I can straight out pay for it and I don't think I'll meet income guidelines for assistance. Any suggestions out there? BTW, my research coordinator says that this is a first for her with the neupogen. Thanks for any feedback.
Much ado about nothing - word just came through that it is approved. And at much less expense to me! It will be shipped to my doctor rather than to me and charged under medical rather than rx which means office co-pay only. Someone at the insurance company actually advised my doc's office to do it that way and it would go through (rare, I think, to have someone that helpful at an insurance company). Now I can savor that UND.
Thanks for your support.
Debra
Thanks for your support.
Debra
It sounds to me like your doctor could be of assistancwe on the insurance issue. Technically, Neupogen isn't being prescribed for you because of HCV treatment, it's being prescribed because of low WBCs (leukopenia). The doc probably has a better diagnosis word than me but I'm thinking the word is leukopenia. If your research team can't help with this then, as Willy50 said, you certainly could get it accomplished by getting the prescription from a Hematologist (blood doc).
Hopefully, you won't need it but it's good to get your ducks in a row. Best of luck!!
Hopefully, you won't need it but it's good to get your ducks in a row. Best of luck!!
A hemo or an experienced Dr may be able to push it through.
You are on chemotherapy just like a cancer patient. It HAS been approved for some in the past. It could be a question of the right doctor using the right coding, or just insisting.
Yes, there is assistance. Check into it before you write it off.
To my way of thinking it is crucial to not get a dose reduction at this stage of the game. Your SVR may hinge on staying full dose for a while.
I am hoping that things stabilize and no rescue drugs are needed. Wouldn't that be great!?
willy
You are on chemotherapy just like a cancer patient. It HAS been approved for some in the past. It could be a question of the right doctor using the right coding, or just insisting.
Yes, there is assistance. Check into it before you write it off.
To my way of thinking it is crucial to not get a dose reduction at this stage of the game. Your SVR may hinge on staying full dose for a while.
I am hoping that things stabilize and no rescue drugs are needed. Wouldn't that be great!?
willy
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