If your health plan removes HUMIRA from a co-pay maximizer program, you will return to eligibility for co-pay assistance up to the maximum annual benefit listed below. This amount is subject to change without notice. For such patients, except where prohibited by applicable state law, AbbVie may discontinue the availability of co-pay support at an amount not to exceed $4,000.00. Since you may be unaware whether you are subject to a co-pay maximizer program when you enroll in the co-pay assistance program, AbbVie will monitor program utilization data and reserves the right to discontinue co-pay assistance at any time if AbbVie determines that you are subject to a co-pay maximizer program.
If you learn your insurance company or health plan has implemented either an accumulator adjustment program or a co-pay maximizer program, you agree to inform AbbVie of this fact by calling 1-800-4HUMIRA to discuss alternative options that may be available to support you. Any out-of-pocket costs remaining after the application of the savings card may not be paid by your health plan, pharmacy benefit programs, or any other program. You also agree that you are personally responsible for paying any amount of co-pay required after the savings card is applied. Except where prohibited by applicable state law, if your insurance company or health plan implements either an accumulator adjustment or co-pay maximizer program, you will not be eligible for, and agree not to use, co-pay assistance because these programs are inconsistent with our agreed intent that this program is solely for your benefit. Co-pay maximizers are programs in which the amount of your out-of-pocket costs is increased to reflect the availability of support offered by a manufacturer assistance program. An accumulator adjustment program is one in which payments made by you that are subsidized by manufacturer assistance do not count toward your deductibles and other out-of-pocket cost sharing limitations.
Some health plans have established programs referred to as “accumulator adjustment” or “co-pay maximizer” programs. By enrolling in the co-pay assistance program, you agree that this program is intended solely for the benefit of you, the patient. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the HUMIRA Complete Savings Card and patient must call HUMIRA Complete at 1-800-4HUMIRA to stop participation.
Co-pay assistance program is not available to patients receiving reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare, Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. Eligibility: Available to patients with commercial insurance coverage for HUMIRA who meet eligibility criteria.
#PROLIA COPAY ASSISTANCE CARD PLUS#
This benefit covers HUMIRA ® (adalimumab) alone or, for rheumatology patients, HUMIRA plus one of the following medications: methotrexate, leflunomide, or hydroxychloroquine.
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