User

Welcome, Guest. Please login or register.
April 25, 2024, 12:26:30 pm

Login with username, password and session length


Forums Index

Stats

Members
  • Total Members: 37652
  • Latest: Han2024
Stats
  • Total Posts: 773289
  • Total Topics: 66348
  • Online Today: 690
  • Online Ever: 5484
  • (June 18, 2021, 11:15:29 pm)
Users Online
Users: 3
Guests: 614
Total: 617

Search

Welcome


Welcome to the POZ Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Do I Have HIV?” posting guidelines. Click here for posting guidelines pertaining to all other POZ community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.
« previous next »
Pages: [1]   Go Down

Author Topic: anthem virginia  (Read 3981 times)

0 Members and 1 Guest are viewing this topic.

Offline gingin

  • Member
  • Posts: 27
anthem virginia
« on: December 03, 2013, 09:42:21 am »
Does anyone know why Stribild is not on anthem's drug formulary for 2014?  I am confused bcause I bought it before on my old anthem insurance policy.  Virginia is limited in insurance choices on new health care act.  thanks
Logged

Offline Jeff G

  • Administrator
  • Member
  • Posts: 17,064
  • How am I doing Beren ?
Re: anthem virginia
« Reply #1 on: December 03, 2013, 09:49:05 am »
Quote from: gingin on December 03, 2013, 09:42:21 am
Does anyone know why Stribild is not on anthem's drug formulary for 2014?  I am confused bcause I bought it before on my old anthem insurance policy.  Virginia is limited in insurance choices on new health care act.  thanks

I cant say why its not covered but I do know that if your doctor wants you on that drug he or she can get prior approval from your insurance company and they will approve it .

I have been through the same thing many times and my doctors have always been successful at getting me what I need and it should not be a problem for you either .
Logged
HIV 101 - Basics
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline Miss Philicia

  • Member
  • Posts: 24,793
  • celebrity poster, faker & poser
Re: anthem virginia
« Reply #2 on: December 03, 2013, 02:52:18 pm »
Is Stribild officially on the "preferred list" for treatment naive patients per the NIH guidelines yet? If not, I can see an insurance company denying it on the formulary. Basically it's not "medically necessary" when there are other options.

I have had medications (though not HIV meds) denied prior approval from my doctor. In fact it just happened last month.

The current preferred list is:

The Panel recommends the following as preferred regimens (listed in order of FDA approval) for antiretroviral (ARV)-naive
patients:
• efavirenz/tenofovir disoproxil fumarate/emtricitabine (EFV/TDF/FTC) (AI)
• ritonavir-boosted atazanavir + tenofovir disoproxil fumarate/emtricitabine (ATV/r + TDF/FTC) (AI)
• ritonavir-boosted darunavir + tenofovir disoproxil fumarate/emtricitabine (DRV/r + TDF/FTC) (AI)
• raltegravir + tenofovir disoproxil fumarate/emtricitabine (RAL + TDF/FTC) (AI)

So, no, Stribild isn't on it. I'm not saying an appeal by your doctor won't work, but I'd also not be surprised if they said you should go on one of those other things unless you can prove with resistance testing that none of those are appropriate. And yes, I can see this becoming more common due to cost.

Hell, I was even denied viral load testing when it initially was approved by the FDA for at least eight months of various appeals by my private doctor, and with a non-HMO Blue Cross (read: expensive) insurance back in ~1997.
« Last Edit: December 03, 2013, 02:55:35 pm by Miss Philicia »
Logged
"I’ve slept with enough men to know that I’m not gay"

Offline gingin

  • Member
  • Posts: 27
Re: anthem virginia
« Reply #3 on: December 09, 2013, 09:32:05 am »
Thanks! I appreciate the info.
Logged

Offline OneTampa

  • Member
  • Posts: 3,021
  • "Butterflies are free."
Re: anthem virginia
« Reply #4 on: December 11, 2013, 07:39:45 am »
All,

Thanks for this info.
Logged
"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."
Pages: [1]   Go Up
« previous next »
 

Terms of Membership for these forums
 

© 2024 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.