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Author Topic: Gilead Advancing Access and Insurance, will it cover me until I reach my OOP  (Read 802 times)

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Offline scottieman

  • Member
  • Posts: 58
I have the humana nationwide POS, I am on stribild, for the first month, I will have to pay just shy of $1,200 out of pocket for my meds, my pharmacy deductible is 500.00 and my max out of pocket is $1,500.00  I will have to pay the 40% co-insurance until my max OOP is met.  Wondering if the advancing access from Gilead will pay the co-insurance until I meet my OOP? once it's met (month 2) then my meds will be covered 100% by humana.  I just can't afford the cost for the first two months...it's almost a months pay for month one.
August 19, 2011 Negative Oral Swap
August 30-September 4, 2011 (Thought Strep throat really sero-conversion)
October 5th, HIV Diagnosis
October 22 labs, CD4 619, VL 21,000 21%
November 13th, Started Complera
January 9th, Labs CD4 631, VL-UD 28%
March 28th Labs CD4 610, VL-UD 31%
July 2nd CD4 792, 34% VL-75
August 7th, 2012 CD4 899, 35% VL-97
September 17th, 2012 CD4 989, 33% VL-27
November 8, 2012  CD4 850, VL-UD, 39%
December 6, 2012 CD4 849, VL-UD, 39%
April 2, 2013 CD4 904, VL-UD, 33%
July 17, 2013 CD4 988, VL UD, 38.2%

Offline emeraldize

  • Member
  • Posts: 3,366
Contact them. The sooner you do that the sooner you will have your answer. And talk with your pharmacist.  I have found them to be quite willing to participate in the process of ensuring patient financial burden is limited as much as is possible.

Offline BT65

  • Global Moderator
  • Member
  • Posts: 10,107
Scottie, you may also want to contact your nearest ASO to assist you with this.  It could save you some headache.  Usually case managers are experienced with this sort of situation, and may be able to move it along faster for you.  Just a suggestion!
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline emeraldize

  • Member
  • Posts: 3,366
While Betty may be onto something with an ASO, having three such co -pay cards of my own with different Pharma companies and very understanding pharmacists--that is the frontline of the process along with your insurer.

Offline scottieman

  • Member
  • Posts: 58
Thank you, great advice!
August 19, 2011 Negative Oral Swap
August 30-September 4, 2011 (Thought Strep throat really sero-conversion)
October 5th, HIV Diagnosis
October 22 labs, CD4 619, VL 21,000 21%
November 13th, Started Complera
January 9th, Labs CD4 631, VL-UD 28%
March 28th Labs CD4 610, VL-UD 31%
July 2nd CD4 792, 34% VL-75
August 7th, 2012 CD4 899, 35% VL-97
September 17th, 2012 CD4 989, 33% VL-27
November 8, 2012  CD4 850, VL-UD, 39%
December 6, 2012 CD4 849, VL-UD, 39%
April 2, 2013 CD4 904, VL-UD, 33%
July 17, 2013 CD4 988, VL UD, 38.2%

 


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