Anyone on Humira and on Medicare and if so how can you afford it

[RussF729824]

My wife is going to be starting Medicare in September 2023 and has been on the drug Humira for over 14 years to control here RA. We have been told she can no longer use the Humira Savers card and will need to pay full price on the Humira and that's thousands a month we have heard. How can our wonderful federal government not allow savings coupons for Seniors. Isn't that age discrimination by the federal government.  Anyone have any suggestions on what to do or other ideas on what to try.

[GailL1]

Lots of details not known to give a complete answer - 

I am gonna assume that she uses the self-injectable type (Part D Medicare) and does not have to get the injections at a provider office (that’s Part B Medicare)  

You won’t pay “full price” if you have a Medicare plan - Part D and once she has reached the (1) donut hole and then the (2) catastrophic coverage, the cost drop substantially.

Would the family income be considered low income ?  If so, there maybe some Medicaid help with the cost.

You cannot use any sort of savings coupons WITH any sort of insurance.  You can ask if she can still participate without using her Medicare coverage (that’s for self-injections).

If she gets Humira injections by her provider - which has coverage under Part B - get the best Medicare plan for your budget - including this cost - be that a MAPD plan OR Traditional Medicare WITH a MEDIGAP plan that picks up the GAP in coverage specifically this Part B coverage.

 If things work out according to legislative plans, the recently passed Inflation Reduction Act limits out of pocket cost for meds in 2025 to $ 2000 per year for seniors, you will be able to plan the cost of Humira per year better - now that is if things go according to plans.

Plus (10) Meds are gonna be selected as the 1st ones for Medicare drug price negotiations - Humira, a biologic med and expensive, might be in this group of first - maybe.  That’s gonna depend on how hard the maker fights back.