Hepatitis C, or hep C, is a type of viral infection caused by contact with the blood of someone with the hepatitis C virus (HCV).
The virus causes your liver to become inflamed, which can lead to symptoms like yellowish skin or eyes, dark pee, gray poop, and abdominal pain.
Some people develop a short — aka “acute” in medical speak — infection where symptoms can be mild or severe but generally resolve in a few weeks. Over half the time, hep C becomes chronic and, especially when left untreated, can lead to some scary complications. Think cirrhosis, liver cancer, and liver damage.
Especially if you catch it early.
It’s a good idea to get regular blood tests if you think you’re at risk of catching the virus. Why? Because 80 percent of people don’t know they have it right away. These regular tests are generally covered by any Affordable Care Act (aka the ACA) health plan.
Oh, and more good news: hep C treatments are known to actually work now.
It’s true that back in the day you had to get a series of injections called recombinant interferon-alfa (IFNa), which caused a whole host of nasty side effects like hair loss, liver damage, depression, and gum disease, all the while only working in 10 percent of cases.
But today, you can take direct-acting antiviral pills, such as Sofosbuvir (Solvadi), ledipasvir-sofosbuvir (Harvoni), or elbasvir-grazoprevir (Zepatier) for 8 to 12 weeks. These drugs are 95 percent effective at treating hep C.
Plus, the side effects, like fatigue and headaches, aren’t nearly as bad.
Especially if you don’t have insurance, hep C treatment can cost a lot — because the drugs themselves are expensive.
For example, sofosbuvir — also known as Solvaldi — costs $1000 per pill. This means that if you take 1 pill a day for 12 weeks, your total cost of treatment is $84,000.
Admittedly, some of the other FDA-approved antivirals are a little less expensive — but they’re still way too high for most Americans. For example, the cost of full treatment with another antiviral called elbasvir-grazoprevir (Zepatier) was $54,600 for a 12-week course when the FDA approved it in 2016.
What this means is that if you don’t have insurance, you might have a hard time affording the medication you need.
Here are some options to consider.
Shop insurance plans
Since the Affordable Care Act was passed, insurance providers, whether they’re employer-provided or on the U.S. Health Insurance Marketplace can’t refuse coverage for anyone with a pre-existing condition. Meaning, a condition you had before starting your new insurance.
So, even if you’re diagnosed with hep C while you’re uninsured, you can enroll in insurance and the provider will have to cover your treatment. The insurance company also can’t drop you because you’re sick.
That said, choose your plan wisely by doing some research into their terms of coverage. Some providers might not cover your treatment until you get very sick — or put restrictions on your treatment by saying they won’t treat you if you use drugs or drink alcohol.
Depending on your income, you might also qualify for your state’s Medicaid program. And if you’re 65 or older or have a disability, you might also qualify for Medicare.
Apply for patient assistant programs
Pharmaceutical companies often sponsor patient assistance programs to give people from low income households access to the medications they need if they’re not enrolled in Medicaid, Medicare, or other government prescription plans.
These programs generally offer free or low cost hep C drugs to people from lower income households who are uninsured or underinsured but don’t qualify for Medicaid or Medicare.
There are also co-pay patient assistant programs available to help reduce your copay or coinsurance for the medication.
To find out what the details of the assistance are and if you’re eligible, you’ll have to check with the pharmaceutical company that makes the medication you’re prescribed.
You can also check the patient assistance program center from Rx Assist.
“The Patient Assistance Program Center from Rx Assist also has an exhaustive directory of other financial aid providers,” explains Nancy Mitchell, a registered nurse. “It’s a great resource for patients wanting to weigh their options before settling on a plan.”
The Patient Advocate Foundation
The Patient Advocate Foundation has a Hep C CareLine to help you get financial and practical assistance while looking for treatment.
You can request help online through their website or by calling 800-532-5274.
Look into clinical trials
You could be eligible for an upcoming hep C clinical trial looking into the safety and efficacy of certain antiviral medications. If you’re accepted into a trial, all treatments and testing will be free — though you will have to pay for any travel costs or other expenses if the trial isn’t local.
You might also be expected to go for routine lab visits or checkups with your doctor during the trial — and those will not be covered financially.
Your doctor can help you determine if you’re eligible for a clinical trial and help you find one, or you can check out the website Clinicaltrials.gov. Your doctor can also help you better understand the costs associated with any trial you enroll in.
Hep C can be a scary diagnosis and while the treatments are very effective, they can be expensive. Even if you’re uninsured or underinsured, you have options to reduce your out-of-pocket costs through ACA health insurance plans, patient assistance programs, foundations, or clinical trials.