If you google Aetna / Harvoni - it has the forms with all the prerequisites for pre-authorization. My doctors filled everything out and I was approved but the meds came direct from Total Care Pharmacy. They were shipped to me. And I have to go to clinic at the liver center every two weeks. I also had a liver biopsy (about a year ago) - no cirrosis, Stage 1 liver disease, Geno type 1. Can't remember what my viral load was. But from what I have read - Aetna is one of the better insurers and has worked out a deal with Gilead - the manufacturer. Good Luck! I JUST started treatment and I have Aetna Insurance.
I also have Aetna through my work. My dr sent the info in about 2 weeks ago. They played with the app for a couple of days. I called and got them to pull the app off the fax machine. They have played with the approval by asking for some info that was on the app, I know because I filled the app out for my dr all but his info. When I called they told me what info they needed and I gave it to them. They played around for a few more days, then Monday they approved the app and sent the approval to my dr. He faxed the prescription on Monday, I called today and the pharmacy has the prescription and was told they would call me in the next 24 hrs with copay and shipping confirmation. I also gave them the copay assistance that Gilead offers as well. I am hopeful I hear from them tomorrow so they will set up shipping.
That is the long version of, about 2 weeks is what you should expect. If I had not made the calls to the insurance company and the Special pharmacy I am sure they would have let this go for a good period of time.
Be active not proactive. Make calls every day until you get what you need. The phone numbers are out there and Aetna has not hid anything, they just try to slow the process a bit. Make sure your dr and you can communicate about the pre cert process. It can be daunting for anyone. Make sure you have copies of all info including your HCV type, biopsy info, prior treatment info, viral load etc..
That way when you call about the approval, you can answer any questions that may need answers. Aetna actually took my info and I had the dr confirm the next day.
Aetna here as well.Did initial ultrasound and blood work early in Jan, pills were on my doorstep Jan 19. 1st script no prob. Second needed more blood work at 2 1/2 weeks. 3rd the MDs office got thstooopid. Got it in time and now into 7th week. MDs office tried to play it off saying I was cured 2 1/2 weeks into treatment. I went from 10,300,000 to under 15. Heavy drinker but I give up alcohol Jan-June for MY lent. Aetna wants proof it's working, that you really need it. I'm grateful for the $5 copay. Specialty pharmacy is great MDs office is not good following up.
This drug was kind of a surprise to the insurance companies but the states etc, have all made their deals so everyone who has insurance should start to be getting the meds if not already. A good strong dr is also good to have to have get thru glitches. Use them as a great resource. You will get your meds and welcome to the cure
- Harvoni Information for Consumers
- Harvoni Information for Healthcare Professionals (includes dosage details)
- Side Effects of Harvoni (detailed)
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