Wellness

[GarlandGal]

I was diagnosed with Rheumatoid Arthritis two years ago. I've been on methotrexate since then, but due to blood test results, my Rheumatologist suggested switching to a biologic, specifically Humira.

I'm on Medicare and have a part D prescription plan through Humana. From checking their website, it appears that my out-of-pocket costs could be up to $6K using my current plan. Yikes!!!

How are people affording this medication? Are there programs offering financial assistance? Or Pharmacy plans that offer better RA medication coverage?

Many thanks for sharing your thoughts or experience!

[jackthebear]

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@GarlandGal wrote:

I was diagnosed with Rheumatoid Arthritis two years ago. I've been on methotrexate since then, but due to blood test results, my Rheumatologist suggested switching to a biologic, specifically Humira.

I'm on Medicare and have a part D prescription plan through Humana. From checking their website, it appears that my out-of-pocket costs could be up to $6K using my current plan. Yikes!!!

How are people affording this medication? Are there programs offering financial assistance? Or Pharmacy plans that offer better RA medication coverage?

Many thanks for sharing your thoughts or experience!

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go to medicare.gov and navigate to the drug plan page, which will show you your state, and plans available

your pharmacist might be able to help to 

[cookie16]

I would speak to my Specialist about this.  Based on income and needing to submit proof to the drug company, there are assistance programs available.  My husband is currently receiving 2 separate drugs available from 2 different Specialty Pharmacies through this assistance. His hematologist took care of the application and we had to submit the proof.  These 2 meds would have cost us about $4000 per month otherwise.  He is also approved through December and the meds are working for him.  Best of luck to you.

[lolakimono]

@GarlandGal 

Have you looked at GoodRX?

[kathie826]

ABbvie makes Humira and I just looked online. They have a patient assistance program. Go to abbvie.com And they show how to get it free accordinggto income. You can apply online. 

[KingstonsMom]

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@GarlandGal wrote:

I was diagnosed with Rheumatoid Arthritis two years ago. I've been on methotrexate since then, but due to blood test results, my Rheumatologist suggested switching to a biologic, specifically Humira.

I'm on Medicare and have a part D prescription plan through Humana. From checking their website, it appears that my out-of-pocket costs could be up to $6K using my current plan. Yikes!!!

How are people affording this medication? Are there programs offering financial assistance? Or Pharmacy plans that offer better RA medication coverage?

Many thanks for sharing your thoughts or experience!

---

@GarlandGal 

Go to Healthwell Foundation.org, they have gov't grants for so many medications for those who are on Medicare.

I use a grant through them to pay for my Prolia for osteoporosis, which even with BCBS and Medicare, my co-pay was unaffordable for me ($1500 every 6 months), now my co-pay is $5.

They have a ton of grants for all kinds of medications/conditions.

HTH!

[grandma2pkmh]

@GarlandGal   I feel your pain.  I am on Humira and it is expensive.  My medicare advantage plan does cover a lot of the expense but my co-pay is high also.  The 1st 2 months of the year my part is a little over $1200.00 then drops to just over $315.00 per month for the rest of the year.  I just have to put it in my budget to save up to pay it.  The only good part is you hit your deductible really quick, skip over the " Donut Hole" and hit the catastrophic portion where the insurance company pays more.

[KingstonsMom]

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@kathie826 wrote:

ABbvie makes Humira and I just looked online. They have a patient assistance program. Go to abbvie.com And they show how to get it free accordinggto income. You can apply online. 

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@kathie826 

From my experience most drug manufacturer's assistance programs are not available for Medicare patients.

DH & I are on several 'specialty drugs' and some of those drug manufacturers are who referred me to HealthwellFoundation.org, since we are on medicare with a supplemental BCBS plan.

[GarlandGal]

Thank you, @jackthebear. I'll do that.

[wenfen]

I have a similar situation with Asthma Meds being insanely expensive.

I would recommend you stay on whatever meds your currently on & then switch to a better Plan D for next year. Maybe a different one would pay more? Do you have an Advantage plan or Medagap? .

Don't forget that there are 3 levels of Plan D. If you pay over the cap then the prices for catistrophic coverage are super low.

You can also contact the manufacturer for discount coupons not using your insurance. You can also try the GoodRX App for lower prices too & ask your Doc about purchasing from Canada for lower prices..

Good-luck!