Humira is a medication that many prescription advocates get asked about. This medication is in high demand because it effectively treats so many difficult conditions like juvenile idiopathic arthritis, psoriatic arthritis, ulcerative colitis, and plaque psoriasis.
Unfortunately, Humira is incredibly expensive - $5,000 - $7,000 a year, even with insurance. Many insurance formularies do not even partially cover it. Fortunately, AbbVie patient assistance foundation has a program that can send out free Humira.
Humira is offered in 20mg and 40mg injections through the AbbVie patient assistance foundation.
WHO CAN GET FREE HUMIRA?
Anyone who qualifies for the AbbVie Patient Assistance Foundation can get free Humira! To qualify for the AbbVie Patient Assistance Foundation, you must have a diagnosis of one of the following conditions: juvenile idiopathic arthritis, psoriatic arthritis, ulcerative colitis, Crohn’s disease, or plaque psoriasis.
Additionally, your household income must be at 400% (or less) of the Federal Poverty Level. For a household of one, that would be $48,240 a year. For a household of two people, that would be $64,960 a year.
For more information about the Federal Poverty Level go to: https://aspe.hhs.gov/poverty-guidelines. Scroll down to their chart. Then find your household number and multiply the dollar amount by 4 to get the AbbVie Patient Assistance Foundation financial limit.
PROOF OF INCOME
You will have to prove your income level by providing financial documents. Acceptable proof of income documents are listed below.
ACCEPTABLE PROOF OF INCOME
The most recent year’s tax documents
Bank statements that clearly list income and the source(s)
Pay stubs (with the year-to-date and pay period on them)
A detailed letter describing the household’s source and amount of income, written by your doctor on their office letterhead
A detailed letter describing the household’s source and amount of income, written by your employer on their office letterhead and notarized
Award letters or current statements for things like Social Security, Unemployment, Workers Compensation, VA Benefits, etc.
For zero income: Just write $0 in the income portion of the application. You won’t need to prove it.
WHAT IF YOU HAVE INSURANCE?
There is also the matter of insurance. If you have prescription insurance, including Medicare Part D, your application will be denied. Not to worry - you can appeal the denial and still get free Humira. This kind of appeal is called an “insurance appeal” and it will require a bit more legwork.
FOR AN INSURANCE APPEAL:
Make a list of all the medications you have been taking over the past 12 months and the strength of each medication.
Make a copy of your insurance card, front and back.
Gather proof of your out-of-pocket prescription expenses (you can get a printout from the pharmacy) and your paid or unpaid household/medical/dental/vision expenses.
AbbVie also requires an explanation of benefits letter from your insurance. It must state whether your Humira is covered or not. If it's uncovered, you will need documentation of your copay amount.
Write a letter to AbbVie explaining your insurance situation and why you still need assistance.
Finally, send all the paperwork back to AbbVie.
LOW INCOME SUBSIDY OR EXTRA HELP
If your household income is less than 135% of the Federal Poverty Level, and you have Medicare, you will also need to apply for the Social Security Extra Help program (also called Low Income Subsidy). You must be denied by the Extra Help program and provide AbbVie with the denial letter. To apply for the Extra Help program and to learn more go to: https://www.ssa.gov/benefits/medicare/prescriptionhelp/
Upon acceptance into the Extra Help program, they should cover your medications. If your Humira isn’t covered, read the Insurance Appeal section of this article (above) to learn about how to get into the AbbVie patient assistance foundation through an appeal.
If you don't have Medicare but your income is under 100% of the Federal Poverty Level (135% if you are in one of the expanded Medicaid states), you will be required to get a Medicaid denial.
HOW DO I APPLY?
Once you’ve gotten your financial documents together, you and your doctor will need to fill out the application. You can find it here: https://products.abbviepaf.org/humira/Patient/Home.
From that page you can choose to fill out the application online and create an account or you can download their application and print it. Click the link above and look for the “apply now” button in the middle of the page if you want to apply on the website. If you’d rather download the application and fill it out on paper, look for the “download PDF form” button.
If you choose to print out the paperwork you will have 2 pages for you and your prescribing doctor to complete. Fill the form out as neatly and completely as possible. You don’t want to get your application denied due to small errors or unanswered questions.
The application has very detailed instructions. However, if you have any questions about how to fill out the paperwork, or what proof of income to send, don’t hesitate to call the AbbVie patient assistance foundation customer service: 1-800-222-6885.
It’s better to spend a few minutes on the phone asking questions now than to have your application rejected later. It will save you so much time and grief.
Once you and your prescribing doctor have completed the paperwork, just fax it (and your financial documents) to AbbVie at this number: 1-866-250-2803. It can take them up to 10-14 days to complete your evaluation.
If you are approved, the Humira can be shipped to either your doctor or your home. AbbVie will call you and set up shipments from there. AbbVie ships 2 pens per box and patients receiving weekly injections will get 6 boxes.
Once you are in the program, you will be approved for almost a year (unless you are a Medicare patient; then you will be enrolled until the end of the calendar year, December 31.) Your doctor will be able to call and order your refills every 75-90 days.
It’s a good idea to keep track of your medication supply and stay in contact with your doctor’s office about when you will need more Humira. Be sure to ask your doctor to reorder before you run out so you don’t experience a gap without Humira.
All prescription medications can be expensive, especially when you are on a fixed income. But, when you need medication just to get through the day, there is no way you can NOT get it.
It seems unfair that something so necessary should be so difficult to afford. With programs like AbbVie Patient Assistance Foundation, you don’t have to make tough choices about what medications you can afford. There are Patient Assistance Programs out there for those who qualify.
If you are struggling to afford Humira to control your pain and other symptoms of juvenile idiopathic arthritis, psoriatic arthritis, ulcerative colitis, Crohn’s disease, or plaque psoriasis, please look into AbbVie patient assistance foundation or other patient assistance programs. You deserve to be happy and healthy.
If you are looking at all these instructions and feeling overwhelmed by the process for enrolling in the AbbVie patient assistance foundation, you might be relieved to hear that you don’t have to go it alone! There are prescription and Medicare advocates at Prescription Lifeline just waiting to help you.
Prescription Lifeline has 15 years of experience dealing with patient assistance programs and Medicare. They have an army of advocates and special software created to make helping people faster, easier, and more accurate than ever.
If you need help getting enrolled in the Lilly Cares Program, Prescription Lifeline can assist you! Contact Prescription Lifeline at www.PrescriptionLifeline.org or call and speak to a patient advocate at 1-888-331-1002. Whether you need help with prescriptions or you’re just curious about getting the best price for your Medicare coverage, Prescription Lifeline is here to help.