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Hep C Discussion Forum -> New Members Area -> Aetna vs BCBS for treatment
Post Info TOPIC: Aetna vs BCBS for treatment
Dzdayscomin


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RE: Aetna vs BCBS for treatment
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The rx part of your insurance is handled by a third party such as expressscripts, they handled mine, and although they denied twice they eventually approved it, but that seems to be std procedure with the off label tx's.

If your dr prescribes an FDA approved tx they really don't have much in the way of denying it, I'm sure with the cost there may be some wrangling to try and go with a cheaper alternative but if your care team is on top of it's game you will win out in the end.

Like I have stated before the new Harvoni is actually cheaper than  both the S/O combo or the Sovaldi with riba etc...so don't see why thet won't  approve.



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fortworthmatt


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Thanks for the info. I spoke to the billing office at my Dr. office and she advised if it was her to go with Aetna. After talking to several people I think I will go with them. I had them in the past and never had a problem and it is only $100 more a month...which adds up over a year but I want to give myself the best chance of getting this new treatment done. I am going with the low deduct as well. I have been waiting several years for these new drugs to come out so I am anxious to start treatment. I didnt let the diagnosis change my life. Since then I have gotten married and had two beautiful girls. My wife accecpted what I had and she is Hep C free. We have just take some precations and not worried about it. But I am ready to get this monkey off my back.



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marktrux


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I used BCBS for years and never had any problems to speak of. Of coarse they have their hoops for you to jump thru, but they all do. If I had to do it over again today, I'd just drop to a lower deduct and dance with the one that brung me.



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Tig


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Hi Matthew,

Welcome to the forum! I also had BCBS during my treatment period, but my prescription benefits were handled by Prime Therapeutics, not Express Scripts. I had very good luck with BCBS and PT. They didn't miss a beat and all medications were both paid on time and without question. The new Harvoni protocol and it's price will present several issues, at least in the short term I believe. It's so new and so expensive, I think the carriers/providers are all going to navigate slowly to begin with. It's going to be one of those wait and see things and we're all anxious to find out how it goes! I wish you lots of luck and hope that you share your experiences with us. It's good to have you here!

Tig



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Tig

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Milliganus


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I have used BC/BS for a few years now. They have been very good at paying for things. We have travelled all over the country for various medical things, and they've paid no questions asked.

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fortworthmatt


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I have the opportunity to change my insurance from BlueCross Blue Shield to Aetna. Has anyone had either one of these companies deny thier treatment? Any thought on high deductable vs low deductable? Also both companies use Expressscripts for perscritpions - so does the healtcare company pay for the drugs or Expressscripts? Thanks for any information to help me make an informed decision. I have BCBS now and a high deduct plan but my deduct has been met and will probably start treatment next month - but at work it is the time of year to pick health plans so I have the choice to choose now (just 2 more days). I am thinking of changing to the low decuct BCBS health plan as I think it will save me money. Thanks guys.



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