![]() I still have the paper work sitting on my desk □ So I'm out $3k+ and I've just moved on. I called and called for over a year and no progress. I had primary and secondary, and they were charging one as the other which ballooned the copay to a bananas amount. The end result for me was not a happy one lol.Įssentially, what was happening was my insurance was improperly submitting claims through the wrong insurance, if that makes sense. It wouldn’t hurt to call Janssen to see if they can offer any additional help though! Unfortunately there likely isn’t anything you can do this year since you already used up the Stelara benefit (the humira program has the same annual benefit whether you get reimbursed or use the card upfront at the pharmacy it doesn’t reset if you change methods) but it could be a game changer for next year. ![]() A lot of insurers are starting to not count savings card payments towards plan limits and so a lot the drug manufacturers are offering reimbursement programs (though they aren’t usually advertised very well). You should see if stelara has a similar program. I was able to get around this by paying the entire amount upfront and getting reimbursed from humira complete rather than using the complete copay card at the pharmacy. I am on humira and the amount the copay card pays doesn’t count towards my deductible or out of pocket max. I have a full-time job, I have insurance, I still have no way of paying that enormous amount of money each month! HELP! I don't know what to do.Īll my best to you all in this trying time. finally have a medication that works for me and now I'm essentially screwed out of my health. That's another $10K but the silver lining (/s) is I'll hit that in two months with the $4-5K cost I'll have to pony up to actually get my meds without the Janssen Carepath help. And now I'm stuck with gigantic out of pocket expenses until my insurance deductible is met. But this year, essentially, I blasted through the $20K they give me per calendar year in three months. Last year at the lower dose it lasted eleven months. My issue at the moment is my Janssen Carepath copay assistance has run out three months into the benefit period. Started at 45mg/8wks and moved to 90mg/4wks I believe. So I've been on Stelara for just over a year.
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