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Humira: The Biologic Marvel and Its Relationship with Medicare

HELPING YOU PUT TOGETHER YOUR MEDICARE PUZZLE

MBG IS AN INSURANCE BROKER AND IS NOT ASSOCIATED, ENDORSED, OR AUTHORIZED BY THE SOCIAL SECURITY ADMINISTRATION, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, OR THE CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS)

jim.neil@medicarebenefitsgroup.com734-657-4797

MEDICARE INSURANCE

MADE SIMPLE

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Introduction 🌈

Humira is a biologic medication that has transformed the lives of millions suffering from autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, and psoriasis. But with its high cost, many patients wonder how Medicare fits into the equation. Let’s unravel the mystery.

What is Humira? πŸ’Š

Humira (adalimumab) is a biologic medication used to treat various autoimmune conditions. By blocking the action of tumor necrosis factor-alpha (TNF-alpha), a protein involved in inflammation, Humira helps to regulate an overactive immune system and reduce symptoms.

The Cost Conundrum πŸ’°

Humira’s effectiveness is unparalleled, but it comes with a hefty price tag. A month’s supply can cost around $5,000 without insurance, making coverage crucial for most patients.

Humira and Medicare πŸ“œ

The good news: Medicare typically provides some coverage for Humira, usually through its Part D prescription drug plans.

Tier Considerations πŸ“Š

Medicare Part D plans use a tier system to categorize medications, and Humira generally falls into a higher tier. This means that while it’s covered, your out-of-pocket expenses may still be significant.

Prior Authorization and Limits βš–οΈ

It’s not uncommon for Medicare to require “prior authorization” for Humira, meaning your healthcare provider must confirm the necessity of the medication. Additionally, there may be restrictions such as step therapy or quantity limits.

Financial Assistance Programs πŸ’‘

If you’re struggling to afford Humira even with Medicare, there’s help available. AbbVie, the manufacturer of Humira, offers a patient assistance program that can substantially reduce the cost for eligible individuals.

Conclusion 🌟

Humira has been a game-changer for people living with chronic autoimmune diseases, offering relief where other treatments have failed. Medicare does generally provide some coverage for this vital medication through its Part D plans, but understanding the specifics of your coverage is key.

So, as we navigate the labyrinthine world of healthcare, the relationship between Humira and Medicare serves as a testament to the importance of insurance coverage in accessing life-changing medications. 🌟

MBG IS AN INSURANCE BROKER AND IS NOT ASSOCIATED, ENDORSED, OR AUTHORIZED BY THE SOCIAL SECURITY ADMINISTRATION, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, OR THE CENTER FOR MEDICARE AND MEDICAID 

SERVICES (CMS)

https://medicarebenefitsgroup.com/contact/

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What Our Customers Have To Say

Shecter Calendar
Shecter Calendar
2023-05-12
Very knowledgeable, friendly, easy to work with.
Cindy
Cindy
2023-05-11
Jim was a great resource who was recommend by my financial advisor. His explanations of the various options were straight forward and very informative. He asked me pertinent questions about my health in order to tailor a plan to best fit my needs.
beth swartz
beth swartz
2023-05-10
very knowledgable
Loventry Robinson
Loventry Robinson
2023-05-10
Jim is patient and very knowledgeable in his work. He helped me to get the Medicare advantage plan I wanted, and I am very satisfied.
Teresa Orr
Teresa Orr
2023-05-10
Jim was very helpful in explaining coverages and explaining the steps I needed to take to get Medicare. I highly recommend him. He is very knowledgeable on all aspects of care and made it easy for me to enroll in coverage.
Laurie Eisenbraun
Laurie Eisenbraun
2023-05-08
Jim was able to provide tailored Medical Gap policy solutions that fit my and my husbands individual needs. Jim is knowledgeable about all the potential policies that could work for us.
Denise Bensch
Denise Bensch
2023-05-04
I want to thank James Neil for making the Medicare Insurance sign up process so easy. He took what I thought would be a frustrating and confusing process, and made it a pleasure. He clearly explained our options and gave us information in an easy to understand manner. I will definitely recommend his services to friends and family.
Chris Bensch
Chris Bensch
2023-05-04
Mr. Neal is extremely knowledgeable & helpful. He did an excellent job of explaining how everything works and presented our options clearly. I'd strongly recommend anyone nearing retirement, considering a benefit change or simply looking for an overview of their options contact him.
Patrick Lennane
Patrick Lennane
2023-05-01
Awesome experience, explained all options clearly and made it easy to make a healthcare decision. Highly recommend!
KATHY TROHA-AUSTIN
KATHY TROHA-AUSTIN
2023-04-24
These two (Jim and Jennifer) were awesome. Extremely knowledgable about the entire process. Would highly recommend them.