Kaiser and Humira

Hi there,

Since it's open enrollment season, I am thinking of switching to Kaiser but wondering if Humira would be covered. I live in the Bay Area and currently on Blue Cross Blue Shield. BCBS costs is getting crazy ridiculous these days and I'm ready to switch.

Does anyone have any feedback on Kaiser (Bay Area) and the costs for getting Humira under Kaiser?

Many thanks in advance!

CH

I have had Kaiser for about 20 years. I began using Humira in February this year. I have had NO problems with this whatsoever. I'm not sure what our plan is called, but normally prescriptions cost us $25 for 100 days as long as you can get generic. Since Humira is not generic, I am charged $35 for 1 month supply. Considering it retails for $2500 per month - that's a steal!!!

If you are still not confident in a particular Kaiser plan then call them and double check.

I live in San Jose, CA btw.

Good luck!

We have Kaiser and I started taking Enbrel in July. I was worried about whether or not it would be covered and they could not tell me my copay until the doctor actually ordered it and it went through the system. I was pleasantly surprised to find our copay was only $20. As tee6395 said, since there is no generic I have to pay by the month but still, considering the regular cost of it is more than $3200 a month, that's okay! We really did not want Kaiser and tried to stay away from it but have found that we really like it and have had no problems in the past two years. We are in So Cal so can't really speak of Bay Area but Kaiser as a whole has been great! I don't know what your particular plan will cover, and what your copay will be, but give it a try...we are loving it. Good luck!

CH, area does not matter only your plan does. Kaiser has agreed on national levels to cover the drug at copay costs. This includes Enbrel and humira. My copay for brand name drugs is $40/ mo because of the plan my company offers. On free exchange you will have the same options at the prices your plan sets for prescription coverage. I agree this is a steal! Kaiser has its ups and downs but once you understand their system it becomes much easier to navigate the care you need. I have used them for years now so feel free to friend and message me if you have further questions. Getting used to how they operate can be tricky.

Thank you for all your replies. I know what to expect going forward when we receive our plan information. I just called Humira too and found out that Kaiser does not accept the Humira Protection Plan but mentioned that there's a form that can be submitted to them (Humira) to get reimbursed if Insurance doesn't accept the card. It's nice to know that there's that option too.