Good Evening, What follows is a detailed description of how one cannot confirm the cost of Humira, costing me $1,600 out of pocket. Spring 2017 Knowing I was to step down from earning income to pursue an unpaid internship that would start in June 2017 I began planning a head. I first contacted my rheumatologist (Whom I’ve been working with at this point for over one year) for an annual checkup to continue Humira which I had been prescribed for nearly one year at the time. The appointment was made. During this appointment it was discussed how the Humira appeared to be wearing off before the next dose was to be administered and the concept of increasing the dose frequency to three times per month was suggested by the Dr. The Dr. then stated that working with the insurances can be “tricky”” in order to get this increase per-authorized. Within a few weeks my Dr. called me and confirmed the approved per-authorization for the administration of three Humira pens per month instead of just two which was the original prescription. I then call my “”Humira Complete Savings Card”” to discuss how the co-pay assistance would influence the moving forward with this new prescription. Keep in mind the is early Spring of 2017. The co-pay assistance staff stated that until there is a charge due to the dispensing of the prescription they would be unable to know whether or not the co-pay assistance would fully cover the new prescription. Up to this point the co-pay assistance was able to cover all but $10 of the cost of my two doses of Humira per month. I then called my rheumatologist and the nursing staff who directly worked with my Dr.
after discussing it with the Dr.
suggested that it was up to me to move forward with the new prescription due to their lack of insight on how much if any I would be charged for the medication. This was alarming to me so I then called my insurance and they also confirmed that until there is a charge for the new prescription (which means I would have to agree to receive this medication WITHOUT anyone who should know to be able to tell me how much I would personally be responsible for) they will not be able to tell me how much it would for me to move forward. My Rheumatologist then encouraged me to move forward with the new prescription adjustment and they will do their best to aid me in finding charities of co-pay assistance foundations that would help me with any out of pocket expense not covered by insurance and co-pay assistance. After roughly four months of preparation for me to A) get a prescription adjustment and B) begin coverage on my wife’s insurance in June (which was set up flawlessly) I decided to move forward with the new prescription. This is where it gets interesting don’t miss this… Promptly
I received my June doses of Humira but instead of the prescribed three doses I received four doses…not thinking anything of it I administer my scheduled dosing a prescribed by my Rheumatologist and while ordering my following months prescription I was informed by my insurance that I now have a $2