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Humira costs

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Posted 12/15/2012 5:18 AM (GMT 0)
What are y'all paying for Humira? For a whole year my insurance was entering my Humira in wrong and with the help of the Humira discount card my copay was only $5.

Well last month my copay jumped to $145 and pharmancy said it was due to a change in my insurance! After calling insurance I was told about their mistake and now this is my correct copay!

So my copay is $645 and the Humira card only covers $500 of it leaving me with the $145!

On top of my $500 a month premiums for my individual insurance I cant afford that!!

Any advice? Wondering if shopping around for another pharmancy trying to get a better price? I just don't know what to do
Posted 12/17/2012 4:50 AM (GMT 0)
Anyone?
Posted 12/17/2012 5:29 AM (GMT 0)
There are resources available, such as at http://www.needymeds.org and other places. You can also call Abbot Pharmaceuticals at (800) 448-6472 and they have people avaiable who can help you find assistance in paying for the drug.
Posted 12/17/2012 11:11 AM (GMT 0)
I am in Canada and mine is covered 80% through my insurance and my husbands insurance covers the other 20%. I am always so shocked to see the price on the bag when I pick it up. How could someone without insurance, on one needle every two weeks, afford $1700 a month??? Not me.....

We have to pay our deductible January 1 again which is $100 each.
Posted 12/18/2012 5:30 AM (GMT 0)
Humira has an assistance program. If you don't have prescription drug insurance and meet the income requirements, you can get the medicine for free. Just go to their website and follow the links.
Posted 12/24/2012 4:33 AM (GMT 0)
My insurance co has decided to not accept the Humira as of Jan. 1, 2013.
Was told that they are doing this because Humira charges to much.
My wife got into it with the insurane company about this and they stood by what they said..
Wife told them that it will affect alot of people and that they probably cannot afford to continue.
we pay $1800/month until our deductible is met then we pay $300/month. This is with the Humira card.. My wife called Abbott and explained what the insurance company was doing and told them that we would not be able to afford it. Mind you that this has been my saving grace and has kept me in remission for the last 3 years. Abbott said that there is a form but we have to pay up front and then send the forms in and then they would reimburse us.
I can't belive the insurance companies thinking behind this.. It really aggravates me!
Anyone else have this similar issue..
Posted 12/24/2012 7:18 AM (GMT 0)
Wolfie,

Even if your insurance formulary is changing you can have your doctor request a Formulary Exception. If the doctor states that you need to stay on the medication for "Continuity of Care" and that stopping or switching the medication would cause an "adverse effect on your health" or would be "dangerous for your health" the insurance company will most likely approve the exception.

They have a very hard time upholding those denials on appeal, especially if you use the new provisions of the Affordable Care Act and ask for an out-side review. Those reviews are conducted by an outside agency established by law and have no bias towards the insurance company.

Here is the link to the info on appeals and External Appeals on the Healthcare.gov website:

http://www.healthcare.gov/using-insurance/managing/appealing-denials/index.html

Let me know if you have any questions.

Jason

Posted 12/26/2012 12:47 AM (GMT 0)
Medicaid?
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