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Author Topic: Florida Insurance Tivicay Truvada  (Read 874 times)

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Offline GoForIt

  • Member
  • Posts: 95
Florida Insurance Tivicay Truvada
« on: December 10, 2013, 02:52:44 PM »
The new ACA is very confusing to me with all of the new available plans and news regarding these new plans.  It is great that the ACA makes it possible to purchase one of these new plans...but everything seems very confusing for someone newly POZ like me.

My current plan is about to expire and I need to choose a new one.  But I want it to cover Tivicay and Truvada, the meds I am currently taking.  I keep reading about different "Tiers" the meds are in and how everyone is confused..is it Tier 2? Tier 4? Tier 5?  How does that affect co-pay?  How does that affect in other ways?  So confusing just to get a simple pill I'm currently already taking!

Is there anyone else who can recommend a good plan?  I live in Florida and find comparing all of these plans very difficult and would really appreciate any help.

Thanks.
08/09/2013   Diagnosed WB positive
08/20/2013   CD4-506(28%)  VL-10,800
09/12/2013   CD4-391(28%)  VL-14,900
09/17/2013   Start ART (Truvada & Tivicay)
10/11/2013   CD4-377(26%)  VL-UD
12/20/2013   CD4-590(??%)  VL-UD
03/18/2014   CD4-660(29%)  VL-UD
07/22/2014   CD4-613(29%)  VL-UD
08/01/2014    Start TAF Clinical Trial

Offline life2

  • Member
  • Posts: 34
Re: Florida Insurance Tivicay Truvada
« Reply #1 on: December 12, 2013, 09:00:38 PM »
Looking at the prescription coverage in a few counties in FL it appears that ARVs are tier two drugs but the copay varies depending on plans and premiums.  Some of the bronze and silver plans appear to have a copay for tier two drugs of $50-75 and others $50 dollars or less AFTER your deductible (~$3000-$6000) has been met.  The gold and Platinum plans don't appear to have the deductible requirement. (note this is just from a quick search of several plans)

It looks like you'd want to select a plan that doesn't have the deductible requirement unless you can swing the full cost for the first 1-3 months depending on your drug regimen.

Do you have an ASO in your area?  I'm sure they've been dealing with these questions a lot.  I'd strongly recommend contacting them asap to discuss the best options for you.


Offline life2

  • Member
  • Posts: 34
Re: Florida Insurance Tivicay Truvada
« Reply #2 on: December 12, 2013, 09:02:13 PM »
Oh, I didn't see Tivicay on any of the covered prescriptions lists though.  I suspect it's because the formularies were put together before the recent approval of Tivicay.  Another question I suspect someone at an ASO can answer.

Offline GoForIt

  • Member
  • Posts: 95
Re: Florida Insurance Tivicay Truvada
« Reply #3 on: December 13, 2013, 04:25:49 PM »
Thanks for the info.
08/09/2013   Diagnosed WB positive
08/20/2013   CD4-506(28%)  VL-10,800
09/12/2013   CD4-391(28%)  VL-14,900
09/17/2013   Start ART (Truvada & Tivicay)
10/11/2013   CD4-377(26%)  VL-UD
12/20/2013   CD4-590(??%)  VL-UD
03/18/2014   CD4-660(29%)  VL-UD
07/22/2014   CD4-613(29%)  VL-UD
08/01/2014    Start TAF Clinical Trial

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Florida Insurance Tivicay Truvada
« Reply #4 on: December 14, 2013, 07:29:24 AM »
GoForIt, if you haven't already, you might be able to find an ASO near you by putting your zip code into poz.com's Health Services Directory. Scroll down and use the second input box - the first one is only for finding testing centers.

Good luck, I hope you get this sorted out to your satisfaction.
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