Figuring out health insurance can be challenging, no matter where you are in your treatment. An Insurance Specialist can help you navigate unexpected changes to your HUMIRA prescription coverage or out-of-pocket costs and help find potential savings.
Get started by exploring different types of insurance, the role of specialty pharmacies, and how we can help you understand your HUMIRA coverage.
Get answers to your coverage questions
- Download our Insurance 101 Guide
- Connect with one of our Insurance Specialists at 1.800.4HUMIRA (1.800.448.6472). Available Monday through Friday from 8:00 AM to 8:00 PM ET, except for holidays.
If your HUMIRA prescription coverage has changed, it may affect your access to HUMIRA and how much you pay. Get the Guide to Understanding Insurance Coverage
Don’t navigate health insurance alone. See how HUMIRA Complete Insurance Specialists can help
The type of health insurance you have determines what's covered, how much you pay, and any additional savings you may be eligible for. Watch the videos to find out more.
Commercial Insurance
See how our Insurance Specialists can guide you through the health insurance process.
Commercial, also known as private, insurance is coverage you get from your employer or buy directly from insurance companies through the marketplace.
Most people with this type of coverage are eligible for the HUMIRA Complete Savings Card, which means you may pay as little as $5 a month, every month, for your HUMIRA prescription.*
*Terms and Conditions apply. Please see full Terms and Conditions here.
Medicare
Medicare is a federal health insurance program for people 65 and older and others with certain disabilities. With Medicare, it’s important to note that prescription coverage is available through many Medicare Advantage Plans (Part C), and Supplemental Plans (Part D)—but you must enroll separately.
People on Medicare who need help paying for their prescriptions may be eligible to receive a low-income subsidy (also known as LIS or Extra Help).
To find out if you’re eligible, there are three ways to apply:
- Online at www.socialsecurity.gov/extrahelp
- Call Social Security at 1.800.772.1213 (TTY 1.800.325.0778)
- At your local Social Security Office
If you're not eligible, HUMIRA may still be available at no additional cost. Please call 1.800.4HUMIRA (1.800.448.6472) to talk to one of our Insurance Specialists for assistance.
Want to know more about Medicare? Check out this helpful guide.
Medicaid
Medicaid is jointly run by the federal government and individual states. It provides medical assistance for low-income individuals and families. State Medicaid programs can provide coverage for HUMIRA—which may vary depending on where you live. To find out the specific coverage policy and information for a particular state Medicaid program, please contact 1.800.4HUMIRA (1.800.448.6472).
Uninsured
If you are uninsured or having difficulty paying for your medication, you may qualify for the myAbbVie Assist Program. It provides HUMIRA patient assistance at no cost to eligible patients who are typically uninsured and/or unemployed and meet certain income criteria. See if you qualify.
Everyone’s situation is different, and prescription drug plans vary widely. Speak with your plan’s representative or a HUMIRA Complete Insurance Specialist.†
They can tell you about your plan's prescription drug benefit and help you avoid treatment interruptions.
To speak with an Insurance Specialist, call 1.800.4HUMIRA (1.800.448.6472).
†Insurance Specialists are available Monday through Friday from 8:00 AM to 8:00 PM ET, except for holidays.
Choosing a health insurance plan
Open enrollment is the time of year when you can renew your current insurance plan, switch to a different plan, and add or drop coverage. Even if you choose to stay with your current plan, it’s important to check for changes to your co-pay and other out-of-pocket costs, provider network, and prescription coverage. If your plan no longer covers your prescription or if your out-of-pocket costs increase, it may be time to consider other plan options.
If you have commercial insurance, open enrollment is typically from early November through mid-December. For Medicare, it runs from mid-October through early December.
Making the choice
If you’re comparing your insurance plan options, use the Insurance Comparison Chart to see questions to consider and a way to view costs for each of your options side by side.
3 tips for understanding your insurance coverage
Whether you stay with your current plan or choose a new one, the amount you pay for HUMIRA may change. Running a Benefits Verification can help you understand your current insurance coverage. Here are the ways to do it:
Call 1.800.4HUMIRA (1.800.448.6472) or click here to learn more about your current insurance plan. This will help you confirm your prescription insurance coverage.
Contact your HR representative or Benefits Manager to see if your new health insurance plan requires a prior authorization (pre-approval) for your medication.
Check with your insurance provider regarding your plan's formulary so that you are aware of which medications are covered.
For more insurance questions and answers, click here.
What is a specialty pharmacy?
A specialty pharmacy distributes complex medications that require special adminstration, storage, and/or handling, such as refrigeration. These prescriptions are either mailed or couriered to you. The use of a specialty pharmacy is often required by your insurance and typically takes a few days for approval.
See how your HUMIRA prescription gets filled, from your doctor’s office to your front door.
Still have questions? Our Insurance Specialists are here to help
Every health insurance plan is different. Here are a few ways your Insurance Specialist can help navigate yours:
- Check your current insurance coverage and determine your insurance benefits
- Check to see if your insurance plan requires prior authorization for HUMIRA or if you need to fill your HUMIRA prescription at a specific specialty pharmacy
- Provide assistance if your pharmacy is unable to process your HUMIRA Complete Savings Card
- Help you find ways that may lower your cost for HUMIRA
- Suggest resources to help you understand the insurance process
- Help you navigate out-of-pocket costs or insurance coverage changes
Insurance Specialists are available Monday through Friday from 8:00 AM to 8:00 PM ET, except for holidays. To speak with one of our Insurance Specialists, call 1.800.4HUMIRA (1.800.448.6472).
Eligibility: Available to patients with commercial insurance coverage for HUMIRA ® (adalimumab) who meet eligibility criteria. This co-pay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law. Offer subject to change or termination without notice. Restrictions, including monthly maximums, may apply. This is not health insurance. For full Terms and Conditions, visit HUMIRASavingsCard.com or call 1.800.4HUMIRA for additional information. To learn about AbbVie’s privacy practices and your privacy choices, visit https://abbv.ie/corpprivacy.
Review your health insurance plan options for Open Enrollment. There may be changes to what you pay.
