Humira not covered by United Healthcare?

[Geophysicist]

I have been taking Humira since 2009 and I think it has worked well. I believe it has addressed many of my Crohn's issues.

Initially, I got the discounted price and have had to only pay $5/prescription. Now, United Healthcare says that Humira is too expensive even with the discount plan and will not cover it, which I don't understand!

Anyone else have this issue? Is there a way around it?

Any advice is appreciated.

 

[Crohn's Mom]

Is it that they wont cover it at all? Or do you have to switch to their mail pharmacy?
We have UHC and my daughter is on Cimzia. Originally we were able to get her prescriptions picked up at Walgreens and it was 3 months worth at a time for one co-pay. Then after a while they sent a letter and we were forced to use their company ~ Prescription Solutions ~ in order to keep getting it covered. They only send one months supply at a time, and we have to call every month to order it, but it's covered, and only a $35 co-pay.
Have you tried calling UHC to ask ?

Best of luck !

 

[lilninja]

Hello,

I have united healthcare too. I'm sad to hear this as I've always thought they were good with their med coverage. I'm currently on imuran so I don't know much about humira or united healthcare coverage for it. Did you try going to the makers of humira and see if they offer help or discounts for it? I wish drug company's/ insurances company's would realize we take this meds to feel better and live a normal life. We don't take them cause we think it would be fun. Make these drugs affordable, help other people get their lives back. I hope you can find a way to get your meds cheaper.

 

[Geophysicist]

Ok, I guess I misread the letter. UHC is saying "Beginning January 2013, UnitedHealthcare's network specialty pharmacies, including OptumRx, will no longer accept manufacturer coupons or cards as payment for Humira"

So I guess this means that my $5/prescription price is over!

 

[Crohn's Mom]

Yep that's it ! OptumRx And actually ~ as long as your Humira co-pay card is still good than they will still allow that
We use a Cimzia co-pay card and it picks up our $35 co-pay too.

I'm glad you misread !

 

[Crohn's Mom]

Unless I just didn't get my letter yet ! yikes ! LOL

 

[Geophysicist]

So after further investigation, UHC just won't take Abbott labs discount card any longer. So my prescription will go from $5/prescription to $60/prescription.

Ridiculous!

 

[Crohn's Mom]

I agree ~ that is ridiculous !

Do they give any reasoning for this ? :/

 

[scoutfinch]

Humira is a "non-preferred drug" with UHC. They initially had rejected my prescription for it, citing that I needed to try Cimzia first before I could try Humira, but luckily my doctor stepped in and quickly won an appeal.

I haven't received any notice from UHC about no longer accepting the Abbott discount, but then again I just started Humira and haven't signed up for the card yet, though I plan to.

 

[Angie10]

Hey...don't know if u have a walgreens near. But here in MN our walgreens has what is called an OPIS card. It comes directly from Walgreens. It is through there specialty services. With this card u pay 5.00 for your Humira. Regardless what your insurance says. It was a lifesaver for me. My co-pay was 40.00 per month. Worth a shot to look into if you have a Walgreens

 

[Geophysicist]

I agree ~ that is ridiculous !

Do they give any reasoning for this ? :/

They don't give a reason. The letter just says that Humira is one of the highest priced medications and that there are cheaper options. It lists Cimzia, Enbrel, Simponi, and Stelara.

 

[Geophysicist]

Hey...don't know if u have a walgreens near. But here in MN our walgreens has what is called an OPIS card. It comes directly from Walgreens. It is through there specialty services. With this card u pay 5.00 for your Humira. Regardless what your insurance says. It was a lifesaver for me. My co-pay was 40.00 per month. Worth a shot to look into if you have a Walgreens

Yeah, I will be looking into that cause $60/prescription is not cool!

 

[Lisa]

Also - do they know why you are on humira? Stelera and enbrel are for psoriasis not for uc/crohns.

 

[Geophysicist]

They do know. The pharmacy mentions it every time I place my order. Maybe there are more clinical tests out now for these drugs.

 

[ctrl z]

There is a clinical trial going on right now for Stelara and Crohn's. I don't know about Simponi.