Today I found out that my Dr wants me to do Harvoni for 12 weeks but that depends on whether or not my insurance company will approve it. Was told if they deny coverage of Harvoni then they will switch it to another drug. My question is what are the disqualifying reasons for getting tx such as Harvoni? I have Blue Cross Bkue Shield insurance. This is all new to me and I have no support system in my life because I don’t feel as though I can share this diagnosis with anyone. I’m just not ready to open up about it yet.
Hi smalltowngirl! First of all, we so commend you for reaching out on here. It’s totally understandable that you’re not ready to open up to those around you yet, but we’re so glad you’ve found our community. Although it may not be time for you to share with those around you in person, I’m so happy that you recognize how valuable the support of others, even virtual friends, can be during this time. We’re here for you, and here to help in any way we can. Regarding your question, there are many reasons why a treatment may not be covered by an insurance agency, and these can vary greatly from medication to medication, and insurance company to insurance company. It can also vary based on individual condition too. For example. two people with BCBS insurance may receive different coverage and treatment options even though they are under the same insurance provider. This can be for a variety of reasons, many of which can be very confusing. A great option you can try is contacting your insurance provider directly and asking them about your specific situation, and what they predict your coverage will be. They may be able to provide you with more information on what they’re basing their decisions and information off of. That may give you a bit of a heads up before you find out from your doctor or health care team. Just a thought!
Again, we’re so glad that you’ve found our community, and we hope you’ll continue to reach out to us. We’re also here if you ever want to talk about strategies for talking with your friends and family in person about this–when you’re ready of course! Thinking of you friend! -Casey, HepatitisC.net Team