Alinia and Insurance

[springfever]

My doctor has agreed to prescibe Alinia, but he has never done it before and does not think ins. will approve it.  For those taking Alinia, did you get pre-approval or just start filling prescriptions?  I've read all the old posts and have a plan if they deny it - Romark or Mexico.  Would appreciate any info on best way to get ins. approval.  I have BCBS.
Thanks

[springfever]

I did get pre-authorized for soc.  My doctor did that first.  It sailed through, no problem.  Thanks for asking!  I love the way forum members watch your back.  

I'm amazed how different BCBS policies can be.  I plan to be aggressive and make a real nuisance of myself, if needed.  A sugary/sweet/southern nuisance.

[Marc1955]

I assume that you have confirmed that your insurance covers the combination therapy without pre-authorization. If you have not, I recommend that you don' take that first shot until you've squared that away. Sometime the pre-authorization can take a while. You don't want to just dive in and then have an unpleasant surprise.

I had a BCBS policy in Maryland that did not cover treatment. Fortunately I found out and was able to switch policies.

[springfever]

Thanks for the info.  I have not set up a pharmacy yet.  Hadn't thought that far ahead.  My first kit was ordered by my Dr. online.  First shot will be at his office.  I'll look for a good pharm. ...lifeline (smile)...reason we're here, huh?

Hope your husband is feeling well these days, Evangeline.  He's lucky to have you.  So is the forum.  I have the Romark address and phone number from older threads on the subject.  You may have been the one who provided it.  I didn't realize it was over the counter in Mexico.  Did know it was cheaper.  I will go that route as last resort.  

Hope you're feeling well too Marc.  Thanks you guys for more info and direction.  

[Marc1955]

Have you identified a pharmacy yet for your treatment? You do have a choice. You don't need to accept the one BCBS steers you to. I use Pharmacare. What you want to find is a skilled, specialized pharmacy that deals with complex medical conditions, such as cancer. For example, the pharmacist from whom I get my medications has been working with HCV since the eighties and was involved with early trials. The pharmacy is one of my most important lifelines.

The pharmacy is in the best position to tell you whether you will have trouble getting the Alinia approved. See if your doc uses someone special for this treatment. If not, I guess you'll need to hunt around. But they can give you the best info.

[evangelin]

It was approved for my husband by having copies of the latest research sent to the insurance company.  My husband had been a nonresponder with cirrhosis so the situation may have helped get the approval.  It is a very expensive medicine for the dosage required for HCV.  It makes me sick that it is over the counter and a fraction of the cost in Mexico.  The teaching hospital that we go to is doing trials with Alinia so that also helped get the approval.  Romark can send all the latest research to your insurance
Co. for review.  Sometimes you have to keep asking until you find the right person to make it happen.  It is worth a shot.  
Best Wishes,
Ev