presence of genotype 1, 2, or 3 also did not affect days to initiation of therapy (40 vs. 39 vs. 42 days, p = NS). The Medicare/Medicaid/Tricare insured patients had less denials as compared to all other private insurers which trended towards significance (5.5% vs. 25%, p = 0.1). Conclusions: Within a structured HCV treatment program, lack of insurance does not delay patients in obtaining interferon free sofosbuvir based therapies. However, insured patients with prescription programs that deny HCV medications needed double the time to obtain therapy and caused burden on the patient and provider. Often these patients obtained medications from charitable access programs provided by the pharmaceutical company. Private insurers were much more likely to deny treatment than government insurance programs. The four companies with the highest denial rates in our population encompass 47% of the market share in the state of Virginia. While the presence or absence of insurance does not affect the initiation of HCV therapy, plans that deny treatment will cause delays in therapy and result in subscribers ultimately applying for patient assistance programs similar to uninsured patients. Insurance Affecting Initiation of Sofosbuvir Based HCV Therapy