I pray it will come thru for you jaro.

I'm so sorry. What were you denied? S & O?

Do you have cause for appeal?

Thanks. Yes, WarriorGal, it was for S&O. I have Cirrohis from this sneaky virus. I had a liver MRI this past week and I will see my doctor next month to go over the results. If you think about it, most surgeries cost more than the price of these meds so I don't understand why all the hassle. I'm sure there is a discount for the insurance companies there somewhere. I hope the price drops soon...

That sucks..theyll pay they are just stalling...patience

Sorry to hear that, Jaro. As someone who works with insurance co's from both angles ( as a practitioner and a customer) I now that they routinely deny a certain percentage of claims figuring people won't make the effort to appeal. But if you do, it goes through no problem. Sending good thoughts that you'll be one of those. B

It feels terrible to receive that news. Brigid is right, tho. Denial is routine. Appeal should get a different answer.

Disability works the same way. They refuse just about everyone and hope you cannot afford the fight.

Contact Gilead. They have a help me line. I called them to ask general what if questions. They said if I was denied and then exhausted all appeals with insurance they have a program so that nobody goes without treatment.

Thank you all for the great info!

Just went to my doctor yesterday. If your doctor prescribed S&O then he did off label which may have been 24 week treatment, versus Solvaldi/inf/RIBA which is only 12 weeks. 12 weeks is half the cost. That could be the reason for denial

@warriorgal..what does "do you have cause for appeal " mean?

you can look up trial in your area as well as calling your doc and get funded for your meds through the companies who make the drugs... Don't despair! There are a bunch of ways to get the funding... talk to your doc and call around for hepatology clinics!!! just takes time!!

I have many health problems and have appealed to insurance more times than most.
So far, if I keep at it (one time took 2 years, bu they finally paid a $10,000 hospital bill....

You are at the mercy of a rep making a critical life decision for you.
Appeal and make them take notice of you....Be kind and appeal to their hearts...

will pray for you

jaro and I have the same doctor. It's a big medical center in Houston, and they are swamped with prescriptions for these drugs. Mine are still in appeal. We have a good doctor and medical team, so I'm hoping we both get our meds. I've been waiting 2 months now. Problem is, a person could die waiting for prescriptions!

Sorry Jaro. Boy Marilyn you hit the nail on the head...a person could die waiting throughout the process. In fact, some might argue that is part of the strategy. And off-label is simply never going to be given to most patients. The pricing is being negotiated & the new meds are coming. Just have to cut through the red tape. This is the real dirty part of pairing politics with healthcare. You & Marilyn have the best team working for you. The waiting continues dang it all!!!!