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Stelara Copay Assistance - Exhausted Janssen CarePath - What else is there?

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Posted 8/5/2022 10:58 PM (GMT 0)
I started Stelara mid-year last year and Janssen CarePath copay assistance covered me for all of my home injections (after the first infusion). This year, I have already exhausted the CarePath copay assistance!

With a high deductible plan and an even higher Max Out of Pocket, it's killing me.

Are there any other copay assistance programs that are NOT income based? A good problem to have, but it seems we make too much for the ones I have tried and the small size of our household (just the two of us).

Thanks!
Posted 8/6/2022 1:26 AM (GMT 0)
I don’t know about stelara, but many of the drug companies have a “no-pay plan”. I get my Aimovig (migraine medication) epi-pens for free. I used to get my Apriso for free when I was taking it. I’m in a little different situation as I am on Medicare and Medicare users don’t qualify for copay programs because of Medicare rules— so don’t know if that makes a difference or not. The “ free” programs are a little harder to find and a bit of a hassle — a yearly application process that your dr has to help with in sending in a prescription and an authorization from insurance. But worth it in the long run. Fairly easy to qualify income wise but they also don’t usually ask for much in the way of credential checking if you know what I mean. You might have to call stelara’s parent company and ask if they have such a program in place. I think they’re usually called patient assistance program — not to be confused with the copay program.
Posted 8/6/2022 1:49 AM (GMT 0)
I don't know how the Stelera co-pay assistance works, but the Remicade co pay assistance (Jansen Care Path) works like this:

The bill is submitted to insurance and Insurance says how much I need to pay until I meet the out of pocket max.
I submit the amount I have to pay to Jansen and they put the funds on my card
I then pay the provider with the Jansen card.

I think my max out of pocket with insurance is $5000 and after my 1st infusion of the year I hit that. Jansen covers all but $5 of that.

The Remicade co pay assistance goes up to $20,000/year and is not income based. What does the Stelera co-pay assistance cover per year? What is your out of pocket max with insurance?

You might have to suck it up until you are eligible to get a different insurance plan. I don't know if you can get Stelera through drug discount sites like GoodRX (there are several others too), but you could check that out.

High deductible plans have lower premiums, but if you have high medical bills it can bankrupt you.

Good luck with finding the least painful solution.
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