MyHumira and Humira Protection Plan – Frequently Asked Questions
What is MyHumira?
MyHumira is an organization that works with patients receiving Humira (Adalimumab) treatment and their providers to verify insurance coverage, identify payer requirements such as prior authorizations, and inform patients of available financial assistance programs.
What is the Humira Protection Plan?
The Humira Protection Plan is a program designed to assist patients to gain affordable access to Humira treatment. If you have insurance coverage through a commercial payer (e.g. Preferred One, HealthPartners, Blue Cross/Blue Shield, Medica, etc) for your prescriptions, the Humira Protection Plan can reduce your monthly co-pay to $5.
Am I eligible for the Humira Protection Plan if I am insured by Medicare or Medicaid?
Unfortunately, the Humira Protection Plan does not provide assistance to those patients who carry governmental health insurance. Please see the next page for additional financial assistance options.
What can I expect from being enrolled in MyHumira?
· Minnesota Gastroenterology (MNGI) will automatically submit your insurance information to the MyHumira program to determine your insurance coverage for Humira
o If your insurance has changed, please call our offices at (612) 871-1145, option 5, and ask to speak with our Patient Financial Counselor. Your new insurance information will be resubmitted to MyHumira for benefits determination
· MyHumira will send you a letter outlining your insurance coverage for Humira treatment
· MyHumira will also refer you to any financial assistance programs for which you may be eligible, including the Abbott Patient Assistance Foundation, which provides Humira at no cost to eligible patients
· Unless your insurance plan requires you to obtain Humira from a specialty pharmacy or you inform our office that you prefer to use a specialty pharmacy, your Humira prescription will be sent to your preferred retail pharmacy on file
· If your insurer requires pre-authorization for treatment, MNGI will submit a prior authorization request to your insurance plan on your behalf
My insurance requires me to get Humira from a specialty pharmacy. What does this mean?
Some insurance plans require patients to obtain Humira from a specialty pharmacy that sends the medication directly to your home. If this is required by your insurance plan, MyHumira will notify our office and the appropriate prior authorizations for your specialty pharmacy will be obtained. The specialty pharmacy will then contact you to establish payment and delivery arrangements.
What if I do not have health insurance?
If you currently do not carry either private or governmental medical insurance or if your insurance does not cover prescription drugs, you may be eligible to receive Humira at no cost through the Abbott Patient Assistance Foundation. For eligibility inquiries, call (888) 486-4723 to speak with a MyHumira counselor.
MyHumira informed me that I may qualify for financial assistance. What happens now?
Use the information provided by MyHumira to begin the application process, if required. All paperwork requiring provider input can be mailed or faxed directly to our Patient Financial Counselor (contact information listed below). If you need assistance completing your application(s), questions can be directed to our Patient Financial Counselor as well. After your application has been submitted, the assistance program(s) will notify you and MNGI of your application status.
Minnesota Gastroenterology, PA
Attn: Patient Financial Counselor
P.O. Box 14909
Minneapolis, MN 55414
Fax: (612) 870-5806
For more information about MyHumira or to expedite the MyHumira enrollment process:
Call (888) 486-4723 or visit their web page at www.myhumira.com
Financial Assistance Options for IBD Medication Expenses
Private Assistance Organizations
The following co-pay assistance foundations help people with inflammatory bowel disease (IBD) pay their out-of-pocket medication expenses. Depending on the type of treatment you and your provider have chosen, you will be able to utilize funds provided by the foundations to cover your medication expenses at your pharmacy or at Minnesota Gastroenterology.* The diagnosis covered by each organization is noted.
Chronic Disease Fund (Crohn’s Disease)
Phone: (877) 968-7233
Web address: www.cdfund.org
Patient Access Network Foundation (Crohn’s Disease)
Phone: (866) 316-7263
Web address: www.patientaccessnetwork.org
Patient Advocate Foundation (Crohn’s Disease and Ulcerative Colitis)
Phone: (866) 512-3861
Web address: www.copays.org
The following organizations may help identify other financial assistance options available to you, regardless of your diagnosis.
Phone: None available
Web address: www.needymeds.org
Partnership for Prescription Assistance
Phone: (888) 477-2669
Web address: www.pparx.org
Phone: None available
Web address: www.rxassist.org
*If you are eligible for assistance from any co-pay assistance organization and will be using the funds at Minnesota Gastroenterology, please inform our Patient Financial Counselor by calling our Business Office at (612) 871-1145, option 5.