Wed-17-12-2014, 05:08 AM
(Tue-16-12-2014, 22:25 PM)jiml Wrote: Can't get in the link, is this about the increase in cost I did find this if it was
Quote:UnitedHealthcare is changing its policy on EnbrelJim,I was reading about the United Health Care and what they are doing to their Enbrel patients.Thank goodness i have Highmark Blue Cross Blue Shield i do pay for my own insurance and have $1200 deductibles $3700 out of pocket.Once i reach these amounts they pay 100%.So i am now starting all over Jan 1st and don't know how much i'll be paying on Enbrel.Right now my insurance is paying for the 4 shots $3000 crazy isn't it.So if I have to pay 20% of $3000 that would be about $600 each month,but before the Enbrel Company gave me a debit card with $8000 on it to help with some of my co-pays.Hopefully they don't copy after United Health Care.You know how that is one will copy after another to save on the almighty dollar.These big company's don't care about us.Hey we the sick people of the world are making them rich.Oh Jim i am learning from you about the Drug Companies I am on a roll and not rock and roll.Ha Ha
Enbrel. Beginning Jan. 1, 2015, UnitedHealthcare will move Enbrel to a "double-step" policy that requires new patients to try and fail two other designated biologics before taking Enbrel. Additionally, UnitedHealthcare's Specialty Pharmacy network will no longer accept copay assistance coupons or cards as payment for Enbrel
What you need to know
Current Enbrel users – This new policy is not a denial of coverage for Enbrel. Enbrel is still covered - however you may see an increase in your copay at the pharmacy counter. You will be required to pay the out-of-pocket cost for your Enbrel prescription, and can be reimbursed through the drug manufacturer.
Future Enbrel users with psoriasis – If you are covered by UnitedHealthcare and your physician determines you should be treated with Enbrel, you will be required to try and fail both Humira and Stelara first.
Future Enbrel users with psoriatic arthritis – If you are covered by UnitedHealthcare and your physician determines you should be treated with Enbrel, you will be required to try and fail two of the four medications on the second tier that are approved for psoriatic arthritis: Cimzia, Humira, Simponi and Stelara.
Be sure to talk with your healthcare provider as they can help you map out the most appropriate treatment for your disease.
What you can do
Copay assistance is still available after purchase of Enbrel by applying for copay reimbursement through the manufacturer. For more information on this new reimbursement process, please contact an Enbrel Support reimbursement counselor at call 1-888-4ENBREL (1-888-436-2735).