Are you in the U.S. and on private insurance? If so, I can tell you about a program for Enbrel called “Enbrel Support”. I have insurance through my job, with copays and an out-of-pocket maximum, but Enbrel is paid in full through the support program, and that’s available to anyone on private insurance no matter what your income! If you’re on Medicare, however, it’s not available. There is something for Medicare patients, but they told me I’d have to pay about $600 a month for Enbrel out-of-pocket and I can’t afford that.
Let me know if you think you might be eligible for Enbrel Support. I should mention Enbrel has been a godsend for me…
Good luck in finding treatments that work for you.
I have medicare advantage, and a couple of the biologicals are covered, but they are tier 5 so my copay is 30%. When I looked at humira, it would cost me about $1800 a month, so that’s not happening.
Enbrel is another one my doc mentioned, but it’s not even covered by my insurance. My brother, who also has psoriatic arthritis and has private insurance, is on humira and gets the copay assistance, so ends up paying nothing for it. They really don’t seem to want to help once you get on medicare.
A miracle happened. My insurance company approved the Otezla, even though they don’t even cover it under my plan. The not so good part is the 1st 90 days will cost over $1800 due to the medicare donut-hole, and then it’s about $180/month for the catastrophic phase. I didn’t want to pay so much since it dips into our retirement savings, but my husband talked me into it. Since we’re near the end of the year, I’m going to wait until the first of the year to start it so I don’t have to pay the $1800 coinsurance again then.
Does anyone have experience with Otezla? The doctor thought it would be best due to not reducing the immune system and not having an impact on the liver. I like the idea of not having to give myself shots.
Do you mean a total of $1800 for the first 90 days, or is that $1800 each month for 90 days? I doubt my husband would agree to that even if I was willing to switch to Otezla.
But, anyway, that’s great news for you! You’ll have to keep us posted on how it goes! I wish you the best, and it would be great if we hear some good feedback about Otezla!
Hi Grandma_J, that’s for the full 90 days - if it was per month, it would be out of the question. As it is, I’m struggling with the idea of pulling that much from our retirement savings, but my husband said he would keep working longer to be able to afford it. He’s a really good guy, for sure.
