Orlando Harmon
Humira (adalimumab) is a specialty biologic drug that is used to treat a variety of conditions, including rheumatoid arthritis, plaque psoriasis, and Crohn's disease. Due to its specialized nature, it tends to be expensive, and patients often rely on their medical insurance to cover the cost of treatment. The extent of coverage provided by insurance plans varies, and several factors determine whether Humira is covered and, if so, to what degree. These factors include the type of insurance plan, the patient's income and resources, and whether the patient qualifies for additional financial assistance or savings programs.
| Characteristics | Values |
|---|---|
| Insurance coverage | Humira is covered by Medicare, including Part B, Part C, and Part D plans. State Medicaid programs may also provide coverage for Humira for $20 or less per month, but it can vary based on your state plan. |
| Cost | The cost of Humira with insurance depends on your insurance plan, dosage, and pharmacy. Medicare Part D plans have different costs depending on deductibles and coverage gaps. As of January 1, 2025, Medicare Part D beneficiaries will pay no more than $2,000 per year in out-of-pocket costs. |
| Savings | The Humira Complete Savings Card can help eligible, commercially insured patients save on the cost of Humira. The card can be added to your mobile wallet to always be ready for treatment. |
| Assistance programs | AbbVie, the manufacturer of Humira, provides a Copay Savings Card program for those with commercial or private insurance. Pharmaceutical assistance programs and Medicare Extra Help are also available to help lower costs for those with limited incomes or resources. |
| Prior authorization | Your insurance company may require prior authorization before covering Humira, which involves discussing the medication with your doctor. If treatment begins without prior approval, you may have to pay the full cost of the medication. |
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What You'll Learn
Medicare Part D coverage
Medicare Part D is a separate part of Medicare that allows you to choose your prescription coverage plan. It is typically used for prescription drug coverage, and as Humira is an injection, it may be covered under Medicare Part D.
The cost of Humira with Medicare Part D can vary depending on factors such as the coverage phase, deductibles, and coverage gaps. The cost of Humira under Medicare Part D can be high, but there are programs available to help lower these costs, such as Medicare Extra Help and pharmaceutical assistance programs.
As of 2025, there is a spending cap on Medicare Part D, meaning you won't have to pay more than $2,000 out-of-pocket on drugs before Part D coverage. This includes the cost of the deductible.
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Medicaid coverage
Medicaid is a U.S. government-run health insurance program that provides medical assistance for low-income individuals and families, or people with certain disabilities. It is jointly run by the federal government and individual U.S. states. State Medicaid programs may provide coverage for Humira for as little as $20 or less per month, but this can vary depending on the state plan. To find out the specific Humira coverage for a particular state Medicaid program, you can contact AbbVie, the manufacturer of Humira, at 1-800-448-6472 (1-800-4HUMIRA).
If you are unemployed or do not have insurance, you may be eligible to receive Humira at no cost from the AbbVie Patient Assistance Program (myAbbVie Assist) or another foundation if you meet certain income criteria. Your eligibility may be based on your insurance coverage, household income, and projected out-of-pocket medical expenses. Other groups, such as non-profit organizations, may also be able to provide financial support for your medications.
It is important to note that the co-pay assistance program offered by AbbVie is not available to patients with federal, state, or government-funded insurance programs, including Medicaid. However, there are other ways to save on Humira, such as the Humira Complete Savings Card, which can reduce your out-of-pocket expenses to as little as $0 a month. Additionally, you can submit your pharmacy receipts and documents through the Humira Complete App to receive electronic reimbursement.
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Cost without insurance
The cost of Humira without insurance varies depending on your Humira dosage, the pharmacy you use, and whether you qualify for the manufacturer's patient assistance program. The average cash price of Humira without insurance is around $7,300 for 1 carton (2 pens) of 40 mg/0.4 mL. However, most people do not pay this much, as there are ways to save on the cost of Humira.
One way to save on the cost of Humira is through the manufacturer's patient assistance program called myAbbVie Assist. This program is available for people who do not have insurance and have difficulty paying for Humira. You can call 1-800-222-6885 to see if you qualify for this program. Additionally, some nonprofit organizations may be able to provide financial support for your medications.
Another way to save on the cost of Humira is through the use of coupons or copay cards. Online coupons or copay cards can help reduce the cost of Humira, especially if you are paying cash and not using insurance. GoodRx, for example, offers coupons that can lower the cost of Humira to as little as $5 per month. However, these coupons cannot be used at specialty pharmacies, which are the only pharmacies that carry Humira.
You may also be able to save on the cost of Humira by enrolling in a Medicare plan that covers the medication. Medicare is a US federal health insurance program for people 65 and older and those with certain disabilities. With Medicare, prescription coverage for Humira is available through Medicare Advantage Plans and Medicare Supplemental Part D Plans, but you must enroll in these add-on plans separately. The cost of Medicare Part D is typically between $346 and $2,109 per month, depending on the coverage phase. As of January 1, 2025, everyone with Medicare Part D prescription drug coverage will pay no more than $2,000 per year in out-of-pocket costs.
Additionally, if you have commercial or private insurance, you may be eligible for the Humira Complete Savings Card program, which can help reduce your copay to as little as $5 per prescription, with a maximum savings of $14,000 per calendar year. However, this program is not available to patients with federal, state, or government-funded insurance programs.
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Savings cards
The HUMIRA Complete Savings Card could help eligible, commercially insured patients save on the cost of HUMIRA. You can request a HUMIRA Complete Savings Card online or through the Complete App and access it whenever you need it. Your Insurance Specialist can also help you get one. If you already have one, have it ready when you fill prescriptions. You can also add your Savings Card to your mobile wallet so you can pay for your treatment easily.
If your pharmacy does not accept the HUMIRA Complete Savings Card or you can no longer use it to receive instant savings at the pharmacy, you may still be able to get HUMIRA for as little as $0 a month using the HUMIRA Complete Prescription Rebate. Submit your pharmacy receipts and documents through the HUMIRA Complete App. Terms and Conditions apply. This benefit covers HUMIRA alone or, for rheumatology patients, HUMIRA plus one of the following medications: methotrexate, leflunomide, or hydroxychloroquine.
The co-pay assistance program is not available to patients receiving reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare, including Part D, Medicare Advantage, VA, Medigap, DOD, or Tricare).
HUMIRA Complete provides your patients with the resources they need when they need them, throughout their whole treatment journey. Insurance Specialists will continue to help patients understand their insurance coverage and potential options to save on HUMIRA.
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Dosage and cost
The cost of Humira varies depending on several factors, including the type of health insurance you have, your coverage, and your out-of-pocket costs. The cost will also depend on which Humira product you require, your coupon savings, and any manufacturer's savings.
The average cash price of Humira without insurance is around $7,300 for one carton (2 pens) of 40 mg/0.4 mL, but most people do not pay this price. Cash prices can vary greatly among U.S. pharmacies, even in the same city.
If you have commercial insurance, you may be eligible for the Humira Complete Savings Card, which can reduce your out-of-pocket expenses to as little as $5 per prescription, with a maximum savings of $14,000 per calendar year.
If your pharmacy does not accept the Humira Complete Savings Card, you may still be able to get Humira for as little as $5 per month or even $0 per month using the Humira Complete Prescription Rebate.
Medicare patients typically have Standard Part D prescription coverage, which has different costs depending on deductibles and coverage gaps. Medicare Part D costs are typically $346 to $2,109 or less per month, depending on the coverage phase. As of January 1, 2025, everyone with Medicare Part D prescription drug coverage will pay no more than $2,000 per year in covered out-of-pocket costs, including the deductible.
State Medicaid programs may provide coverage for Humira for $20 or less per month, but this can vary depending on the state plan.
If you do not have insurance or are unemployed, you may be able to receive Humira at no cost from the AbbVie Patient Assistance Program (myAbbVie Assist) or another foundation if you meet certain income criteria.
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Frequently asked questions
Medicare typically covers Humira, but it depends on whether it is administered at home or in a doctor's office. Medicare Part D may cover the cost of Humira when a person administers it at home, while Part B may cover the cost if someone receives the medication as an outpatient.
The cost of Humira with insurance depends on your insurance plan, dosage, and pharmacy. You can check with your pharmacist or insurance company to find out the cost specific to your plan.
There are several ways to save money on Humira. The Humira Complete Savings Card can help eligible, commercially insured patients save on the cost of Humira. Additionally, Medicare Extra Help and pharmaceutical assistance programs can help lower costs for those with limited incomes or resources.
If you do not have insurance, you may be able to receive Humira at no cost from the AbbVie Patient Assistance Program (myAbbVie Assist) or another foundation if you meet certain income criteria. You can also explore options such as biosimilar products, which tend to cost less than brand-name medications.
You can contact Humira Complete at 1-800-4HUMIRA (1-800-448-6472) to speak with an Insurance Specialist, who can help you understand your coverage options and out-of-pocket costs. You can also check with your insurance company directly to see if prior authorization is required for Humira.
