HUMIRA Complete Enrollment

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Enrollment
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Section
Enrollment
Hidden URL Panel
Hidden Validation Error Message Panel
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Hidden API Error Message Panel

Create an online account.

HUMIRA Complete is designed for people with a prescription. If you don't have one, we'll provide you with helpful information about HUMIRA and your condition.

What condition have you been diagnosed with?

To enroll in HUMIRA Complete, you must be taking HUMIRA for a condition that is FDA approved for treatment.

Select your reason for signing up for HUMIRA Complete :

I am prescribed HUMIRA

I am not prescribed HUMIRA but want to learn more

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Oops! Something went wrong. Please try again.

Start Date

We ask for your start date so your Nurse Ambassador can get to know you better and provide you with a more personalized experience.

MM/DD/YYYY

First Name

Last Name

Email Address

Your email address is used to log in to HUMIRA Complete. Be sure to record this information, including your password, and keep it in a safe place.

Already have an account? Log in

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Where do you get your current insurance?

From my employer, or I buy my own through The Marketplace

I am covered through a family member's insurance plan

I'm on Medicare (including Advantage and Supplemental Plans)

I have a government-funded, Medicaid, or VA insurance plan

I don't have insurance

This type of health insurance is offered through an employer or the Affordable Care Act.;;

A spouse may be covered through the spouse’s insurance plan, a child up to age 26 may be covered on a parent’s insurance plan, and dependents may be covered on a family member’s plan.;;

Prescription drugs are covered under Medicare Supplemental (Part D) and most Medicare Advantage Plans (Part C). You must enroll in these plans.;;

Government-funded plans cover federal employees, retirees, their families, and TRICARE enrollees. Veterans Affairs (VA) offers health care services for veterans.;;

Select the items that will help make managing your treatment easier.

HUMIRA Complete resources are available at no additional cost.

HUMIRA Complete Injection Training Kit

Choose the Injection Training Kit for the HUMIRA Pen or syringe for step-by-step instructions and visual guides of the injection process.

HUMIRA Complete Insulated Travel Case

The Insulated Travel Case makes it easy to take your HUMIRA medication with you, store it, and keep it at the required temperature (36°F to 46°F). Also included are tips for traveling with your medication.

HUMIRA Complete Sharps Container and Mail-back Disposal Kit

The Sharps Container holds up to a year’s supply of used Pens or syringes (or up to 6 months if you take HUMIRA weekly).

The Mail-back Disposal Kit contains a postage-paid box and appropriate stickers for a convenient way to return your full container.

To make sure we send you the correct Injection Training Kit, which HUMIRA device do you use?

HUMIRA Pen

HUMIRA prefilled syringe

Would you like a new Sharps Container, a Sharps Mail-back Disposal Kit, or both?

Sharps Container

A box and mailing label to return my full container

Enter your mailing address. We'll save it so you can order more resources later.

Street Address

Address 2 (optional)

City

State

ZIP Code

Receive reminders via:

Send email reminders to:

When would you like the reminders to start?

Date

MM/DD/YYYY

How often would you like to receive your reminders?

Every:

1 week

2 weeks

What time of day would you like to receive your reminders?

Select a time zone:

Select hour:

Select from 15-minute time slots:

:00

:15

:30

:45

Please check the box to indicate you understand and accept these Terms and Conditions:

Phone Call

Send phone call reminders to:

Phone Number

When would you like the reminders to start?

Date

MM/DD/YYYY

How often would you like to receive your reminders?

Every:

1 week

2 weeks

What time of day would you like to receive your reminders?

Select a time zone:

Select hour:

Select from 15-minute time slots:

:00

:15

:30

:45

Please check the box to indicate you understand and accept these Terms and Conditions:

Text Message

Send text reminders to:

Phone Number

When would you like the reminders to start?

Date

MM/DD/YYYY

How often would you like to receive your reminders?

Every:

1 week

2 weeks

What time of day would you like to receive your reminders?

Select a time zone:

Select hour:

Select from 15-minute time slots:

:00

:15

:30

:45

Please check the box to indicate you understand and accept these Terms and Conditions:

Hidden Phone Number

Set up your Nurse Ambassador preferences.

To match you with a Nurse Ambassador, we'd like to find out a little more about you.

What's the best time to contact you, Monday-Friday?

Morning

Afternoon

Evening

Any time of day

Primary Phone

The phone number you provide should be a mobile number where an Ambassador can leave voice and SMS text messages. Only your Nurse Ambassador will make calls to this number.

Hidden Un Formatted Phone Number

Please do not leave voice messages at this number.

hidddenAllowVoicemail

Complete your account profile.

The condition you selected is for pediatric patients.

You must be the child's legal guardian and 18 years of age or older to enroll in HUMIRA Complete on behalf of the child.

Are you a patient or pediatric caregiver?

I am a patient

I am a pediatric caregiver

Date of Birth

We ask for your date of birth to ensure that you are 18 years of age or older and to help us recognize your registration record.

MM/DD/YYYY

ZIP Code

This is used to help match you with a local Nurse Ambassador.

Gender

Male

Female

I am the child's legal guardian and am 18 years of age or older.

Child's First Name

Child's Last Name

Child's Date of Birth

MM/DD/YYYY

Child's Gender

Male

Female

ZIP Code

This is used to help match you with a local Nurse Ambassador.

hiddenIslegalguardian

IsAbove18

hidddenZipCode

Your Contact Information

Name:

Email Address:

Primary Phone:

ZIP Code:

Your Personal Information

Diagnosed Condition:

Start Date on HUMIRA:

Birth Date:

Gender:

Insurance Coverage:

hiddenDiagCondition

Edit Your Contact Information

First Name

Last Name

Email Address

Primary Phone

Please do not leave voice messages at this number.

ZIP Code

This is used to help match you with a local Nurse Ambassador.

Edit Personal Information

Diagnosed Condition

Child's Diagnosed Condition

Diagnosed Condition:

To enroll in HUMIRA Complete, you must be taking HUMIRA for a condition that is FDA approved for treatment.

Are you a patient or pediatric caregiver?

I am a patient

I am a pediatric caregiver

I am the child's legal guardian and am 18 years of age or older.

Start Date

MM/DD/YYYY

Date of Birth

MM/DD/YYYY

Gender

Male

Female

Where do you get your insurance?

From my employer, or I buy my own through The Marketplace

I am covered through a family member's insurance plan

I'm on Medicare (including Advantage and Supplemental Plans)

I have a government-funded, Medicaid, or VA insurance plan

I don't have insurance

This type of health insurance is offered through an employer or the Affordable Care Act.;;

A spouse may be covered through the spouse’s insurance plan, a child up to age 26 may be covered on a parent’s insurance plan, and dependents may be covered on a family member’s plan.;;

Prescription drugs are covered under Medicare Supplemental (Part D) and most Medicare Advantage Plans (Part C). You must enroll in these plans.;;

Government-funded plans cover federal employees, retirees, their families, and TRICARE enrollees. Veterans Affairs (VA) offers health care services for veterans.;;

Edit Your Child's Information

Diagnosed Condition

Child's Diagnosed Condition

Diagnosed Condition:

To enroll in HUMIRA Complete, you must be taking HUMIRA for a condition that is FDA approved for treatment.

Are you a patient or pediatric caregiver?

I am a patient

I am a pediatric caregiver

I am the child's legal guardian and am 18 years of age or older.

Start Date

We ask for your start date so your Nurse Ambassador can get to know you better and provide you with a more personalized treatment experience.

MM/DD/YYYY

Child's First Name

Child's Last Name

Child's Date of Birth

MM/DD/YYYY

Child's Gender

Male

Female

Where do you get your insurance?

From my employer, or I buy my own through The Marketplace

I am covered through a family member's insurance plan

I'm on Medicare (including Advantage and Supplemental Plans)

I have a government-funded, Medicaid, or VA insurance plan

I don't have insurance

This type of health insurance is offered through an employer or the Affordable Care Act.;;

A spouse may be covered through the spouse’s insurance plan, a child up to age 26 may be covered on a parent’s insurance plan, and dependents may be covered on a family member’s plan.;;

Prescription drugs are covered under Medicare Supplemental (Part D) and most Medicare Advantage Plans (Part C). You must enroll in these plans.;;

Government-funded plans cover federal employees, retirees, their families, and TRICARE enrollees. Veterans Affairs (VA) offers health care services for veterans.;;

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Set up your security preferences.

Create your password.

Your password must be a mix of 8-16 alphanumeric characters (including uppercase and lowercase letters and numbers) and symbols (e.g., !@#&).

Strength

Weak

Medium

Strong

Show Password

Almost done! Please review and accept the terms below.

AbbVie provides personalized support programs. AbbVie, its affiliates, collaborators and agents (“AbbVie”) will use your personal information, including your health information, collected through your enrollment and participation in the programs to: 1. provide you with AbbVie product-related support and communications; and 2. perform research and analytics.

By enrolling, I represent that I am the patient's legal custodial parent or an authorized personal representative of the patient under applicable state law.

I would like to receive news and updates about AbbVie's products, clinical trials, research opportunities, programs and other information that may be of interest to me.

For more information about AbbVie’s privacy practices and your privacy choices, visit www.abbvie.com/privacy.html.

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