Medication costs

I know there are members from all over here.

I’m wondering how much you pay for med? And how do you pay.

I’m about to start humaira. When talking to the pharmacy it will be 1700 a month (2 doses). My medical benefits will pay 80% and my husbands the other 20%. So essentially it is fully covered. My problem is I have to pay out of pocket first.

I’m just wondering how others do it?

I am in that boat too, my Humira is $2900.00 per month (2 doses) and I have to pay out of pocket first also.

I called Humira and they are very helpful, so I would like to suggest that you call Humira (1-800-HUMIRA) and discuss with them, they may be able to help you with the out of pocket and they also have a $5 a month card.

I’ve asked for a vacation day on Thursday I.m going to give Humira a call as well as my insurance company to see if there is any way for the pharmacy to direct bill them. I’m not hopeful but it is worth a shot

Like you, Dakotasun, I’m in Canada. Our government health system does not cover prescription medications until the costs reach a certain percentage of a family’s income. Many of us have private health coverage for prescription drug coverage. My policy covers 90% of my prescription costs, which I used to think was very generous. But at $1800 a month for Enbrel, I’m certainly feeling the $180 co-pay.
When I turn sixty-five, I will get government seniors’ coverage, which has one very low (I believe $6, but I may be wrong) co-pay for all drugs.
Good question, it’ll be interesting to hear what others have to say.

My humira will cost what my husband makes in a month. I have a long way to go before I hit seniors benefits. My plans are great. But it’s the out of pocket cost that has me worried I won’t be able to afford it even thought I will get fully reimbursed

Yes, the out-of-pocket costs while you are waiting for reimbursement can be quite a burden when it’s thousands every month. My pharmacy bills directly to my insurance, thank goodness. In the case that you can’t get an arrangement like that from your insurance, would it be possible to pay with a credit card, hoping that the reimbursement comes before you have to pay the credit card bill? (If you time it right, you can get at least a month’s lead time.) If you use a credit card with rewards, even better! Alternatively, you may have to take a loan to cover the first month’s prescription, and then after that, the reimbursement should cover the next month’s bill.
Tricky stuff.

I am in the US. My insurance is through my husband's job. I pay just a $10 co-payment monthly for the bios I inject, like Enbrel, Humira, and Simponi all of which I have been on in the past. For Remicade infusions I have not paid anything.

When I was on Enbrel, because of the prescription assistance program it was free for 6 months then $5 a month after that. I'm on Humira now and through the Humira prescription assistance program it costs $5 per script. One thing I've figured out is the specialty pharmacy I have to use gives me one prescription per month ($5 per month) for the first three months then they will begin to ship three months at a time ($5 co-pay for three months). Also it is very expensive for the first dose then it gets cheaper after that. I have no clue why this is but my first month of Humira was billed at $1500 and the recent months have been around $850. I can't figure out their pricing!

The 800-4HUMIRA people are very easy to work with and it doesn't take much time (15 minutes tops). I think I went online and printed out a temporary card then I called them to activate it, then they sent me real card in the mail. So I was able to record the temp card with the pharmacy and start getting the benefits before I had actually called Humira. They are really proficient (between 8a-7p).

And my insurance has a high deductible ($1250) before co-pays kick in. For some reason they send the full cost to insurance even if you only pay $5 out of pocket.