Anyone get financial assistance from enbrel?

[lucyjlou]

I just found out today that starting jan 1st, my insurance will have a $5000 a year cap on prescriptions. That means, that since my enbrel is like almost $2000 a month, I am only getting like 2-3 months of this covered! Right now, I have no cap and just pay $30 a month copay...

I know enbrel has programs for people with no insurance coverage. When I called, he said to call back after the 1st, when prescription changes and they will assess the situation and either give it to me free or charge a copay...

I was wondering if anyone else has used their program and how it worked for you. Do you pay a copay, if so how much? How is it determined? do they ship it to you, or you get reimbursed and still go to pharmacy, how does it work?

thanks!

[RichJ]

hi lucy,
sorry i can't help much but i can bump you to the top. maybe some one will come throught and help with your ?

have a good night all

richard

[MikeK]

Hi Lucy,

Yikes! I'm so sorry. :(

Enliven Services (http://www.enbrel.com/psoriatic-arthritis/insurance-help.jsp) was able to help Sue (beachbound) significantly lower her Enbrel related expenses by arranging for her to get Enbrel from a mail order pharmacy. (Even if they no longer offer that service; a mail order pharmacy is something that you can also explore.) She discusses her experience in the following threads:

http://www.psoriasis.org/forum/showthread.php?t=11307;

http://www.psoriasis.org/forum/showthread.php?t=11753.

You also might want to give the NPF a call. They have an insurance advocacy service that goes to bat for people who are having insurance issues. Here's a link to their descption of their service: http://www.psoriasis.org/advocacy/assistance/insurance/index.php and here's a link to their contact information: http://www.psoriasis.org/contact/.

Finally, I'm going to give you a link to a thread that was started by Leslie (Momtotwogirls). She took the time to post the links and information about some assistance programs that she came across. I added the links and information to programs that people have either told me about or that have been discussed here on the board. Some of these programs say that they provide co-payment assistance. We don't know very much about most of thse programs, but I can tell you that several people were able to get assistance from either Enbrel's patient assitance program -- which is called the ENcourage Foundation (http://www.encouragefoundation.com/) or from a program called www.needymeds.com. Www.needymeds.com sounds like a scam site, but Miranda (LadyFraser) was able to get Enbrel for free while her husband was transitioning from being self employed (with no insurance) to working for the government (with excellent benefits thanks to www.needymeds.com. Jessica (stormechaser) was able to get both Enbrel and Remicade thanks to www.needymeds.com. Links to their stories can also be be found in Leslie's thread. Here's a link to it: http://www.psoriasis.org/forum/showthread.php?t=12379.

I hope this helps.

Good luck. Keep us posted!

Mike

[LillyPie]

I get Enbrel from the Encourage Foundation - set up by Enbrel. They ship the Enbrel to my house once a month. My husband is self-employed and with my pre-existing conditions... I have no insurance. My husband has insurance, but I'm considered "uninsurable" unless I get on through a group plan. That is the plan... if I could ever find a teaching job.

Back to the free Enbrel. I feel so blessed to get my meds for free. The Encourage Foundation is so good to me - everyone is so nice and willing to help with anything I need. I am getting ready to re-apply for the year and they did change things. I have to apply for state medicaid, get declined, and then I can continue getting assistance from the Encourage Foundation. I called the Encourage foundation back when I had short-term insurance with no prescription coverage. They told me that because I have insurance I was ineligible for their assistance. Once this insurance ran out... I called again and was able to get accepted.

I just wanted to let you know that they do provide assistance - I don't know if you'll be able to get it through their Encourage Foundation or not.

Anyone out there that does not have insurance - I highly encourage you to contact Enbrel. I only have positive things to say about my experience. Good luck!!