Don't despair! The insurance companies are frequently denying the first request. It's because they're unable or unwilling to part with nearly $100K or more without making it hard on the patient. As a F4, you can remind them that the current guidelines established by the insurance industry and the AASLD that clearly states advanced fibrosis/cirrhosis demands approval. The words unethical and immoral come to mind. Don't take no for an answer.
Jill and Wendy are right, appeal the decision immediately and get your doctor to fight for you. They know what they have to do, they just have to do it. Encourage them to be an advocate, not a road block. We also have a large list of assistance programs that can offer advice and payment assistance. You can access that information through the link in my signature line below.
Regarding your most recent posts, there is a way that was just set up so you can add an easy link in your signature line to access that information. Just follow the instructions and you'll have an easy way to the threads that you've participated in. Here's a link to those instructions: My Posts
wendyo said
May 8, 2016
Cayo,
please try to keep positive and ask your higher power to help you. Your doctor can appeal direct to the insurance company and if they won't, you need a new doctor. Mine fought for me. Please check this out as well:
http://www.mysupportpath.com/forms-and-resources
Don't give up. Don't use no matter what.
wendy
Cinnamon Girl said
May 8, 2016
I`m sorry to hear this, Cayo, I`m surprised you`ve been denied. Please don`t despair though, the next step is to appeal this decision. Other people here have been denied and then have had their treatment approved on appeal, and I wouldn`t even consider going down the generics route.
I know this must be a huge blow to you, but hang on in there, you`ll get your treatment in the end, it`s just going to take a bit longer than you were expecting.
To find your previous posts, look in your `User Details`, and there you`ll see a box marked `Profile` on the left hand side, and underneath that you`ll find a box headed `Posts`. You`ll see where it says `Member Posts` and `Topics Started`.
If you need advice on going through the appeal process there are others here who`ll be able to guide you through.
Good luck! Stay calm and keep your chin up, you`ll get there...
cayohueso1 said
May 8, 2016
Hey everybody, this is cayohueso1. Ive been looking for responders to previous posts except that I cant find my previous posts! Id like to blame it on the constant migraines and the deep brain fog, but I'm thinking that its probably a simple case of I don't know how to navigate around the forum. Got something to tell you all, and I'm sick inside. My doc has been trying to get me approve for Harvoni, and I just received a letter today from Cigna saying Ive been denied. Stage 4 on the scale,why did they deny me? I cried all over my dog while he licked my face. Very Very depressed. Started pounding the internet and I saw a website called FIXHEPC. and like the word fix was in red on top of the word Hep. This website says they have generic Harvoni in a handful of other countries at a fraction on the price. CHECK IT OUT! Fraction of the price, something like 1,600 for 12 weeks( I need 24) theres a place to upload your script and your ID. Then you go on to payment page. I think Ive got a copy of my script but I sure as hell don't have 3,200 at the moment . But I can pull it together by the 1st of July. WHAT DO YOU GUYS THINK OF THIS?? Ive been told this can take months or years. Docs nurse told me they requested more info. before they can approve it. What kind of info? (How much Excedrin do I take on a weekly basis to keep my head from blowing off my shoulders....?) I wanna save for the generic..whadaya all think?? Tearing my hair out in Key West...cayohueso1
(Edited to reduce blank space. ..Jill)
-- Edited by Cinnamon Girl on Sunday 8th of May 2016 04:12:25 AM
Hi Cayo,
Don't despair! The insurance companies are frequently denying the first request. It's because they're unable or unwilling to part with nearly $100K or more without making it hard on the patient. As a F4, you can remind them that the current guidelines established by the insurance industry and the AASLD that clearly states advanced fibrosis/cirrhosis demands approval. The words unethical and immoral come to mind. Don't take no for an answer.
Jill and Wendy are right, appeal the decision immediately and get your doctor to fight for you. They know what they have to do, they just have to do it. Encourage them to be an advocate, not a road block. We also have a large list of assistance programs that can offer advice and payment assistance. You can access that information through the link in my signature line below.
Regarding your most recent posts, there is a way that was just set up so you can add an easy link in your signature line to access that information. Just follow the instructions and you'll have an easy way to the threads that you've participated in. Here's a link to those instructions: My Posts
Cayo,
please try to keep positive and ask your higher power to help you. Your doctor can appeal direct to the insurance company and if they won't, you need a new doctor. Mine fought for me. Please check this out as well:
http://www.mysupportpath.com/forms-and-resources
Don't give up. Don't use no matter what.
wendy
I`m sorry to hear this, Cayo, I`m surprised you`ve been denied. Please don`t despair though, the next step is to appeal this decision. Other people here have been denied and then have had their treatment approved on appeal, and I wouldn`t even consider going down the generics route.
I know this must be a huge blow to you, but hang on in there, you`ll get your treatment in the end, it`s just going to take a bit longer than you were expecting.
To find your previous posts, look in your `User Details`, and there you`ll see a box marked `Profile` on the left hand side, and underneath that you`ll find a box headed `Posts`. You`ll see where it says `Member Posts` and `Topics Started`.
If you need advice on going through the appeal process there are others here who`ll be able to guide you through.
Good luck! Stay calm and keep your chin up, you`ll get there...
Hey everybody, this is cayohueso1. Ive been looking for responders to previous posts except that I cant find my previous posts! Id like to blame it on the constant migraines and the deep brain fog, but I'm thinking that its probably a simple case of I don't know how to navigate around the forum. Got something to tell you all, and I'm sick inside. My doc has been trying to get me approve for Harvoni, and I just received a letter today from Cigna saying Ive been denied. Stage 4 on the scale,why did they deny me? I cried all over my dog while he licked my face. Very Very depressed. Started pounding the internet and I saw a website called FIXHEPC. and like the word fix was in red on top of the word Hep. This website says they have generic Harvoni in a handful of other countries at a fraction on the price. CHECK IT OUT! Fraction of the price, something like 1,600 for 12 weeks( I need 24) theres a place to upload your script and your ID. Then you go on to payment page. I think Ive got a copy of my script but I sure as hell don't have 3,200 at the moment . But I can pull it together by the 1st of July. WHAT DO YOU GUYS THINK OF THIS?? Ive been told this can take months or years. Docs nurse told me they requested more info. before they can approve it. What kind of info? (How much Excedrin do I take on a weekly basis to keep my head from blowing off my shoulders....?) I wanna save for the generic..whadaya all think?? Tearing my hair out in Key West...cayohueso1
(Edited to reduce blank space. ..Jill)
-- Edited by Cinnamon Girl on Sunday 8th of May 2016 04:12:25 AM