Humira for Ulcerative Colitis

Has anyone had any luck getting their insurance to pay for Humira for treatment of Ulcerative Colitis? My insurance just denied and I plan to appeal.

With my insurance provider last year, I had no problem getting humira approved. However, when I switched insurance providers at the start of 2012 they denied it. My doctor basically took it upon himself to wake war against them and they eventually approved it. Was definitely a shining point for my gi.

     At the time I was on Humira I had Personal Choice Pa Blue cross and Blue shield.  No problem whatsoever!  All I paid was the $5 co-pay.  Same with Remicade.  Neither biologic worked though..but...was I ever glad I had the Personal Choice back then and when I had my operation because I am now on Medicare (turned 65 last Aug) and boy, are they ever a pain in the butt!  I have Keystone 65 special for my secondary insurance.

     To give you a small inkling about Medicare....when I ordered my ostomy supplies in Sept Medicare okay'd the stoma powder and deodorizing drops that I place in my bag..but...they did NOT ok the bags... .  OY what morons!  Edgepark had to send my surgeon three different forms in January to fill out and send back to them so Medicare would give their seal of approval for my supplies.  Why three forms?  Because Medicare was not satisfied with filling out just one form.  My surgeon's office is so busy and I was embarrassed, but they said they are used to this. UGH!

I was on humira for 3 months and my insurance paid all but the $20 co pay. I was on a weekly dose the last month and it covered that as well.

I had all sorts of trouble getting my insurance to pay for Humira (Humana). They flat out denied me. I appealed twice, I believe, and after that I was accepted into the Abbot Patient Assistance program. It's a lot of pushing papers and a big pain to do. You have to get your doctor involved to fax over necessary paperwork and such and it could take several weeks to get it going but now I get my Humira delivered to my workplace for FREE in a big ice chest. They send me 6 pens at a time and when I need to refill all I have to do is call. I started the program in June and I know it lasts a year and then you have to re-apply but as far as I know as long as you have documentation that you've filed with your insurance, have record of every appeals and denials, then you should be able to be accepted to the program. Once you get in the Abbott people that I deal with on the phone (i.e. ordering) are very, very nice and they give you an exact date when you're medicine will be delivered so you know when it is coming.

Here's the website: http://www.abbottpatientassistancefoundation.org/

Like I said, the process was tedious, but in the end it was worth it. I have my medicine.... and it's free.