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Real members of MySpondylitisTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Enbrel And Medicare

A MySpondylitisTeam Member asked a question 💭
Windcrest, TX

Will be switching to Medicare in a few months and in researching my options I'm finding Enbrel will cost me about $5000 more per year than it does on my current health insurance. What have other people done when moving to Medicare?

April 23, 2021
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A MySpondylitisTeam Member

Don't take me wrong, but there's a thing about doctors, embrel is a big ticket item for doctors to prescribe, they make great incentives, if you're struggling to cover a medication, that stress alone, will keep you much sicker, I'm truly not trying to pry, but I know stress really hurts us in bad ways, I'm in pretty bad shape but I don't know about embrel

January 16, 2023
A MySpondylitisTeam Member

Sandie, hello.
I don't take Enbrel or any other drugs like that. But insurance packages for medicare patients like Humana, United Healthcare have programs that include, doctor visits, prescriptions, and hospitalizations that are all part of the package for the same price as what you pay for medicare. These insurance packages are all based on medicare guidelines. I have found for myself that it is cheaper out-of-pocket costs to be in Humana or United Healthcare than using just Medicare. I don't know much more than what I have expressed here.

Call the different insurance companies and they will go over their packages for Medicare recipients and if you like one of them you can sign-up with them so when your Medicare kicks in you can be with the package you want that is best for you. The insurance people that you will be talking to are very helpful, that is what I found them to be when I went on Medicare and started looking for a better deal for myself.
I ended up going with United Healthcare when I first got into my Medicare age and I left them when they decided they were going to limit how much morphine I could have each month. That decision should be between me and my doctor, not some snot-nosed kid reading from a script as I like to call it. Good Luck, make your first call and it is easier after that.

July 15, 2021
A MySpondylitisTeam Member

The Saftynet foundation will pay you copay All of it, download the application and send it in. It has to be done Every October.

May 27, 2023
A MySpondylitisTeam Member

Medicare doesn’t pay for any injections you take at home. Before Medicare I tried Enbrel, Remicade, Humera, and, Simponi, Now on Medicare, shots must be given at the office so she switched me to Cimzia. I’ve not found anything that works for me. On all medications, I never paid anything. The individual companies for Enbrel and Humera has freebies you can sign up for. A.S. sucks, but having a drug that works sure would make it easier.

March 30, 2023
A MySpondylitisTeam Member

Go to the manufacturer and see if they have a place there where you can get the medicine. Was not having so much copay because I think it's a tier 3 medicine. I'm not sure I could be wrong and generally those are very high. What I did on my type 2 diabetes. I went to Lily cares and I requested that I get on there and I gave them my income and I get my trillicity and my insulin with no copay and they ship it to me lol

November 10, 2022

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