Discussions that mention humira

Arthritis board


It's hard to be off of your meds while you heal. I had a biopsy last December and couldn't start the new medicine my rheum wanted me to take. When I finally got healed up enough to start it, I broke my ankle and had to have surgery on it. No meds again until it was almost completely well. Your immune system has to be able to function to heal so that is why we can't take meds that suppress the immune system.

Each insurance plan is different. I don't mind sharing what mine does and does not cover, but yours will probably be different. Our prescription coverage is a 3 tiered system: generic, formulary and non-formulary. Generic drugs are $5, formulary drugs you pay 30% and non-formulary you pay 50%. For the very expensive, injectible drugs like Humira or Enbrel, I must use a special pharmacy and have $100 co-pay per month. It must be paid before the meds are shipped. Remicade is an amazing drug BUT my insurance company requires I order it through the specialty pharmacy. Most rheum's want to administer it and then bill for it. Doing it that way, it is covered at 80% once you have met your deductible and out of pocket. I had 3 infusions before I realized my rheum was billing for it. That situation ultimately led to me firing him. Be very sure you jump through the insurance hoops on Remicade because one infusion can run between $6,000-$8,000. You do NOT want to get stuck with that bill.

We have an benefits book that is updated every year and I can call my benefits manager at work if I have a question about what is and isn't covered. RA is an expensive disease so it's worth the time and energy to become familiar with the ins and outs of your policy.