Deana Devries

I have a hard time getting my Humira covered. I still end up paying a lot of money every yr. I am on Humira plan too it is a mess! I hear that some get it for $5 a month but it is impossible for me to do that with Health Net. My question is anyone getting Humira for $5 or very low co pay? Can anyome recommend a better insurance company. What insurance works well with Humira?

Asked by Deana Devries 3 years ago humira insurance




Chapps
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Excuse me, everyone - but there's some misinformation here. I've been completely covered by two different health plans during the time that I've been taking Humira, and I signed up first thing for the Humira Protection Plan. Normally, I'd pay a nominal $30 copay for a month's worth of injections (two injection pens), and another $30 for my MTX, but both are covered under the plan for a grand total of $5. It's the drug company that subsidizes the cost, and I don't believe that it has anything to do with your insurance. You should have received a Humira info packet with your first dosage of the drug, and in it you should have found the Humira Protection Plan card with a big sticker saying call 1-888-486-4723. But you have to have the card - it has the 5 sets of numbers needed when you're on that call.

If you didn't get the card and packet, call your doc immediately to get it.

by Chapps 3 years ago

Sherry
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Hi!  My brother had a prescription for either humira or enbrel (not sure which one) and when he went to pick it up at the pharmacy, his "co-pay" was $1,600.  The pharmacist then called his insurance company and they covered it under the "major medical" portion of his insurance instead of the prescription portion.  I think it was then covered 100% (not sure if he had a deductible).  I am on remicade, via infusion every 5 weeks in my doctor's office.  It is covered 100% (I was on Humana and am now on Blue Cross).

by Sherry 3 years ago

Catherine Terry
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I used to get Enbrel free (to me) from some chronic disease assistance plan - it wasn't through the drug company it was some other foundation. I met the income / expense guidelines of not being able to afford the drug after my insurance paid their part (and we made very good money at the time). I agreed that after the first year, I'd start to increase the amount I paid for the Enbrel. I never got that far, though, as I had to stop taking Enbrel before the year was up. Anyway, keep asking around because there are all sorts of programs out there to help pay for the medication. If you don't ask, they assume you can afford it.

by Catherine Terry 3 years ago

Samantha Peterson
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I'm on United Healthcare PPO through work.  My co-pay is normally $60 for Humira but with the copay assistance program I pay $5 per month and take Humira weekly.

by Samantha Peters...  3 years ago

Deana Devries
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My insurance requires me to pay $3000 out of pocket before they pay anything once I reach $3000 they pay 100%.  HUMIRA or Opus pays $500 per month for me that is their maximum and I still have $1200 left until I reach $3000 so I am now applying for healthwell they are suppose to be able to assist with the rest up to $2800.  I have no idea why they make is so hard but if this all works out I shouldn't have to pay anything for my meds.  Pray this all works out for me.  Until next year!

by Deana Devries 3 years ago

Michael Rowley
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I wish I could give you mine! I was approved for the $5 dollar copay but have yet to fill even one prescription. I can't bring myself to order it due to some skin cancer concerns. I am a state employee and we have crappy insurance so thats probably the reason I was approved for the low copay on the Humira plan.

by Michael Rowley 3 years ago

Dorathy Griffith
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The same thing happened to me on United. It seems if you are insured at all, your copay is gonna be too much even on the "patient protection plan". I gave up for lack of funds. Now my doctor is gonna try me on embrel. Anyone have experience with  that?

by Dorathy Griffit...  3 years ago

Rita
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I have a Humira card that pays my copay in full for 6 months and then I have to pay 20 per month for 6 months.  I have also had The HealthWell Foundation help me. That is an orginazation that helps with overages after your insurance pays its part. They have paid up to 5,000 per year for me.

by Rita 3 years ago

Ginny Reel
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Call Abbott, company that makes humira, and ask if they have a program to help you. I know they have copay assistance but they also have a very generous program that provides the drugs free if your insurance doesn't cover humira. I'm not sure what the cutoff is, but I think if your family income is less than 100 k you can qualify (it might be up to 150k but not sure). It took 2 phone calls and a fax to enroll. It was a life saver for me since my insurance only covers generic rxs. (mortgage payments or medicine?). In the future be sure to ask your doc when going on a new drug because many have plans to help under insured patients.

by Ginny Reel 3 years ago

Jerry Grynspan
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It's not the insurance that lowers the cost. My official co-pay is $60 but I only pay $5. The drug company will subsidize your co-pay. The mail order pharmacy that my insurance company forces me to use for high priced drugs did all the paper work but you may find it on the humira website.

www.humira.com/global/financial-assistance.aspx

by Jerry Grynspan 3 years ago

Chris
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I'm on Blue Cross, Blue shield. I just went weekly and I get all 4 injections for $5.00 now. I hope you can get this taken care of soon. I know how it is with issues and it makes me so angry that we can't get help on our medication. THey think we are made of money. I have one now that is $60.00 and the dr. Just ordered me to 4 a day. It's called Apriso. It really helps but I have a feeling it won't be 60. It will be more. I will be calling the drug maker to see if I can get help. You have to call each one to see and hope for the best. Never give up, keep searching to find a way. :)

by Chris 3 years ago

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I have a hard time getting my Humira covered. I still end up paying a lot of money every yr. I am on Humira plan too it is a mess! I hear that some get it for $5 a month but it is impossible for me to do that with Health Net. My question is anyone getting Humira for $5 or very low co pay? Can anyome recommend a better insurance company. What insurance works well with Humira?

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