Frequently Asked Questions about Reimbursement
Click on the questions below to view the answers.
Insurance Reimbursement Services Available through myHUMIRA
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myHUMIRA reimbursement counselors can help by contacting your health insurance company on your behalf to identify coverage options for HUMIRA. Please have your insurance card ready when you contact 1.800.4.HUMIRA (1.800.448.6472) so we may expedite your request.
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Our myHUMIRA reimbursement counselors at 1.800.4.HUMIRA (1.800.448.6472) can assist you with insurance coverage issues related to HUMIRA. Reimbursement counselors can contact your health insurance company to verify your benefits and determine whether HUMIRA is covered by your health plan. For patients with no insurance coverage for HUMIRA, reimbursement counselors will search for alternate coverage options that may provide access to HUMIRA, including referrals to the HUMIRA Patient Assistance Program.
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myHUMIRA reimbursement counselors can research prior authorization requirements and can help facilitate the process for your physician when allowed by the physician and your insurance company.
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myHUMIRA reimbursement counselors can provide information about co-pay assistance programs offered through independent and public charities for eligible patients.
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Typically, the pharmacy that is providing HUMIRA will submit a claim to your insurance plan on your behalf. However, if you are required to submit a claim for reimbursement for HUMIRA, myHUMIRA Reimbursement Services can provide information about the claim submission process. myHUMIRA is not able to submit claims to insurance plans on your behalf.
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myHUMIRA reimbursement counselors can help appeal unfavorable coverage decisions. We can contact your insurance plan to determine why HUMIRA is not covered and can research options to obtain coverage. We also have materials to assist you and your physician in advocating for coverage, such as draft letters of medical necessity.
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myHUMIRA reimbursement counselors can research your eligibility for alternate sources of coverage based on your specific situation. When available we will provide you with the steps for obtaining coverage for HUMIRA through an alternate coverage source. Candidates who appear eligible may also be referred to Abbott’s Patient Assistance Program for HUMIRA.
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Accessing myHUMIRA Reimbursement Services
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You can reach a myHUMIRA reimbursement counselor by calling 1.800.4.HUMIRA (1.800.448.6472) Monday through Friday, 8 a.m. to 8 p.m. Eastern Time.
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myHUMIRA reimbursement counselors are available to assist you Monday through Friday, 8 a.m. to 8 p.m. Eastern Time.
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No. You are not required to register with myHUMIRA in order to begin treatment with HUMIRA. However, you will be required to provide myHUMIRA with information about your insurance plan if you would like to obtain reimbursement assistance. myHUMIRA is a voluntary patient support program that is available at no charge.
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You can obtain reimbursement assistance through myHUMIRA prior to treatment or at any point during treatment.
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You can obtain your assistance through myHUMIRA Reimbursement Services by calling 1.800.4.HUMIRA (1.800.448.6472) or by completing and submitting an enrollment form available at your physician's office.
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There are two enrollment forms in order to better address the specific needs of each patient. Patients who have insurance coverage that may provide coverage for HUMIRA should complete the myHUMIRA Benefit Verification and Statement of Medical Necessity for Insured Patients. Patients who have no insurance coverage or who have confirmed that their insurance plan will not provide coverage for HUMIRA should complete the Patient Assistance Program Application for Uninsured Patients. You will need to work with your physician to complete the appropriate enrollment form. For questions about these enrollment forms and the enrollment process, please contact a reimbursement counselor at 1.800.4.HUMIRA (1.800.448.6472).
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The HUMIRA Patient Assistance Program can accept tax returns, paycheck stubs and social security statements for proof of income. Reimbursement counselors can provide additional information about acceptable proof of income documents.
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Payer Questions
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Many health insurance companies provide coverage for HUMIRA. However, some managed care organizations may require prior authorization for patients to obtain HUMIRA. myHUMIRA reimbursement counselors are available to help customers evaluate coverage options for HUMIRA.
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Most state Medicaid programs provide coverage for HUMIRA. To find out the specific coverage policy and guidelines for a particular state Medicaid program, please contact 1.800.4.HUMIRA (1.800.448.6472) to speak with a HUMIRA reimbursement counselor.
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The Medicare Prescription Drug, Improvement, and Modernization Act allows Medicare beneficiaries the opportunity to enroll in prescription drug plans that may help pay for the cost of self-injectable biologic medicines like HUMIRA. These new drug plans could make HUMIRA coverage more available to you. To learn more about the recent changes to Medicare and what they can mean for you, please visit www.medicare.gov or call 1.800.4.HUMIRA (1.800.448.6472).
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