- Is Hep C care and medication covered by insurance?
- How can I find a Hep C doctor?
- What if I don’t have insurance?
- What if the Hep C med is not approved by insurance?
- Where can I find help?
Hep C medical care and medications are covered under Medicaid, Medicare and private insurance for many patients. Seeing a medical provider experienced in treatment advocacy can help get the medications covered more quickly.
- Find health insurance through the NY Marketplace here.
- Medical providers can use the free online resources Cover My Meds to faciliate the prior-authorization process.
To find a Hep C doctor in NYC:
- See our Site Locator resource page.
- Visit www.nyc.gov/health/sitelocator and search “Hepatitis C Treatment”.
- Text LIVER to 877 877.
Through the New York State Department of Health HepCAP program, several NYC health care centers are able to provide free hepatitis C medical care for uninsured or under-insured patients, including undocumented persons.
- Appeal: A Hep C medication denial can be appealed. Medical providers and patients can contact the health insurance company to file an appeal.
- Fair Hearing: If the medication is still not approved after the appeal, a Fair Hearing can be requested. A Fair Hearing is a chance for you to tell an administrative law judge why you think your health insurance should cover your treatment.
- A grievance or complaint should be filed if a recommended medication is denied. Filing a grievance or complaint is the only way health insurance regulators will know there is a problem with patient care.
Community Health Advocates offers resources to assist providers and patients in filing appeals, fair hearings and greivance or complaints. Give them a call to get started: 800-614-5400.
- Patient navigators can help you get medical care and treatment:
- The Check Hep C patient navigation program serves patients with hepatitis C at health care facilities in Brooklyn, Manhattan and the Bronx.
- The Project INSPIRE care coordination program serves patients with hepatitis C at health care facilities in northern Manhattan and the Bronx.
- There are NYS Hep C Comprehensive Care Programs in the Bronx, Queens, Harlem and Brooklyn.
- Pharmaceutical Assistance Programs cover the cost of Hep C treatment and copays in some cases (Harvoni: Gilead Support Path, VIEKIRA PAK ProCeed Patient Assistance Program, or Zepatier Merck Patient Assistance Program ).
- Community Health Advocates offers resources to assist providers and patients in filing appeals, fair hearings and greivance or complaints. Give them a call to get started: 800-614-5400.
Still need help with the cost of care? Email firstname.lastname@example.org and we will do our best to help you.