It’s only a couple weeks into the new year and I already know that I will only pay $5 for all my health care for the year (plus approximately $140 per month for insurance). Here’s how!
It Starts with Selecting the Right Health Insurance
When I signed up for health insurance through my employer, I picked a plan that covered all my medical expenses 100% after I meet my deductible. It is actually not even the most expensive plan and will end up saving me more money in the long run and I get way better coverage! With my expected high use due to my chronic illness, it is definitely worth it!
How I only paid $5 AND met my deductible
I am currently taking Humira to treat my Crohn’s Disease. This medication is valued at $4,000-5,000 per month!!! My deductible is $2,700 – so that is the portion I am responsible for. On January 2nd, I filled my prescription for Humira and had to pay my co-pay. Here’s where it gets good:
Humira has two options to help you with payment for your medication:
- HUMIRA Complete Savings Card – Used when paying your copay for your prescription – this assists you with your payment and you can pay as little as $5. This is used before your payment of $5 and depending on how your pharmacy bills your insurance, it might count towards your deductible.
- Rebate through CompleteRebate.com – Used to refund your prescription copay so you pay as little as $5. This is used AFTER you pay your copay, and therefore will be counted towards your deductible. << I recommend this one if you can handle the bill up front, that way it’s guaranteed to be used towards your deductible.
*** Terms and Conditions apply. Scroll here for details >>>>>>>>>>>>>>>>>> This benefit covers HUMIRA® (adalimumab) alone or, for rheumatology patients, HUMIRA plus one of the following medications: methotrexate, leflunomide (Arava®), or hydroxychloroquine (Plaquenil®). Eligibility: Available to patients with commercial prescription insurance coverage for HUMIRA who meet eligibility criteria. Copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the HUMIRA Complete Savings card and patient must call HUMIRA Complete at 1-800-4HUMIRA to stop participation. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from the HUMIRA Complete Program from any third-party payers. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums, may apply. This is not health insurance. Please see full Terms and Conditions.
So putting it all together, this is how it worked! I filled my prescription at the beginning of the year. The total cost was $4,991.96. My insurance paid everything after my deductible ($2,291.96), Humira’s rebate paid $2,695 (everything left after insurance but $5), and I paid five whole entire dollars and met my deductible in the process.
I also get the added benefit of being on an insurance plan that covers 100% after my deductible so unless I go to a doctor out of network, I won’t pay another penny for any medical treatments or appointments for the rest of the year.
How is this even possible?
Think about it this way : Humira makes almost $5000 per month (that’s $60,000!!!) just from my prescription alone. By assisting patients in getting their cost covered, they are making tons of money from the insurance agencies covering most of the cost. Even after paying $2,695 for my prescription, they are still making $57,305 for the rest of the year.
How To Apply this Hack to Your Health Insurance?
Obviously, not everyone is taking Humira, but many manufacturers have similar programs like the Humira Savings Card. GoodRx is a really awesome resource I’ve found to check on your prescriptions to compare costs and information on over 680 active copay cards. Here are 20 of the most popular copay cards:
|Brand drug||Copay card savings|
|Advair||Save up to $50 per fill|
|Breo Ellipta||Pay as little as $10 per fill|
|Dulera||Save up to $90 per fill|
|Eliquis||Pay as little as $10 per fill|
|Humalog||Pay as little as $25 per fill|
|Humira||Pay as little as $5 per month|
|Invokana||Pay as little as $0 per fill|
|Januvia||Pay as little as $5 per fill|
|Lantus||Pay as little as $0 per fill|
|Levitra||Save up to $150 per fill|
|Lyrica||Pay as little as $25 per fill|
|Premarin||Pay as little as $15 per fill|
|Proair||Pay as little as $25 per fill|
|Proventil||Save up to $15 per fill|
|Restasis||Pay as little as $5 for a 90-day supply|
|Spiriva||Pay as little as $0 per fill|
|Symbicort||Pay as little as $0 per fill|
|Truvada||Save up to $300 per month|
|Vyvanse||Save up to $60 per fill|
|Xarelto||Pay as little as $10 per month|
Even if you have a copay after your deductible is met, these savings cards could help you keep costs down!
You’ve got this!
Getting this savings pushed through my pharmacy, insurance and rebate program has had it’s own struggles. Remember that even though health insurance is supposed to help you, it can be very stressful, confusing, expensive and will test your patience. Just a reminder that you’ve got this!! You have made it this far in life and you’re not going to let a little struggle get the best of you.
Be kind, but very clear on what your needs are when speaking to health insurance representatives. Take notes on WHO you talked to and WHEN (bonus points if you save the extension number of someone that really helps you out so that you can continue working with them through the process of whatever you’re working on).
Best of luck to you and your health this year!
Have any health insurance hacks? Share them in the comments below!