Prescription Drug Coverage

Does Medicare Cover Humira?

Many Medicare Advantage plans and Medicare prescription drug plans cover HUMIRA. Learn more about HUMIRA and Medicare prescription drug coverage.

Reviewed by Hayden Gharibyar, Pharm.D.

HUMIRA (adalimumab) is the best-selling drug in the U.S., with over $21 billion worth of sales.1 But is HUMIRA covered by Medicare?

While Medicare Part A and Part B don’t typically provide coverage for retail prescription drugs, HUMIRA is covered by most Medicare Part D prescription drug plans and Medicare Advantage plans that include drug coverage.2

Find $0 premium Medicare Advantage plans that cover HUMIRA.

Speak with a licensed insurance agent

1-800-557-6059

Is HUMIRA covered under Medicare?

Original Medicare (Part A and Part B) does not provide any coverage for HUMIRA. Only a private Medicare insurance plan may provide such coverage, such as a Part D plan or a Medicare Advantage (Part C) plan.

How much does HUMIRA cost with Medicare?

With a Medicare Part D or Medicare Advantage plan, you may have an annual deductible. The deductible is the amount that you must pay out of pocket during the year before the plan pays anything for your prescription drugs.

Some Medicare Advantage plans and some Part D plans may include a $0 deductible for drug coverage.

Once you meet your plan deductible, you are typically required to make copayments (a flat fee) or coinsurance (a percentage) for your prescriptions that are covered by your plan.

Plan availability, costs and coverage can vary from one plan to another. Be sure to check with your Medicare plan formulary to find out if HUMIRA is covered by your Medicare plan and to find out more about your costs.

How does HUMIRA help treat arthritis?

HUMIRA is a brand name drug used to relieve pain and reduce inflammation for:

  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Crohn’s disease
  • Ulcerative colitis
  • Psoriasis
  • Hidradenitis suppurativa
  • Uveitis
  • Juvenile idiopathic arthritis

HUMIRA is an injectable drug typically taken with a syringe or pen device.

How much does HUMIRA cost without insurance?

HUMIRA can be very expensive when not covered by insurance. According to GoodRx, two injectable pens of HUMIRA have an average retail cost oof $9,338 if you are paying out of pocket.2

Compare Medicare plans with drug coverage

You can compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

A licensed insurance agent can also help you compare Medicare Advantage plans available in your area that provide prescription drug coverage.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover HUMIRA.

Find $0 premium Medicare Advantage plans that cover HUMIRA.

Speak with a licensed insurance agent

1-800-557-6059

1 Anderson, Maria. (Aug. 13, 2020). 20 top-selling drugs in the US. Becker's Hospital Review. https://www.beckershospitalreview.com/pharmacy/20-top-selling-drugs-in-the-us.html.​

2 GoodRx. Humira. www.goodrx.com/humira.

Christian

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.

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