you have/had trouble getting Enbrel covered? Our current insurance gave me NO trouble at all. I get 3 months worth for $80. COmpany is contemplating changing insurers so I need to discuss this with my boss. Thanks so much!

I have Humana PPO here in Florida and I had no problems getting enbrel. Co-pay was $30 for a month's supply.

When I was using Enbrel I had ConnectiCare (in CT). My derm did have to fight for it, but it was approved and my copay was somethng like $35.00 a month if I remember correctly. I have Aetna over here in AZ. I'm not sure if it allows Enbrel.
Annie

I'm in NYC and have Cigna. My Enbrel co-pay for 3 months is $150, but that's for 50mgs 2X a week.

I am in North Carolina and thought I had a form of Blue Cross/Blue SHield for state employees. My card reads "MEDCO" for office visits and medications. I have had no trouble getting ENbrel covered.
MK

I have United Healthcare - PPO. I also get 3 months for an $80 co-pay.

I have bc\bs of Illinois, but drugs are thru Caremark. I had to get a letter from my doctor, but it was approved as soon as they got the letter. A new letter is needed every 6 months. I pay $60 for 3 months no matter what the dose.

Enbrel was $20 per month, just my copay. Doc had to write letters but otherwise no problem. Thats been over year now since I've had it.
Since I cleared with uvb and other regimines and remain clear I would no longer qualify for enbrel.

I found it very easy to qualify for Enbrel with United Healthcare... I had Enbrel fax my doctor the forms to fill out and send to my insurance company. Within a few days they said "okay" and I filled the prescription through Pharmacare in Chicago. They overnighted the medicine to me. Really easy. And it was only a $7 per month copay..
I'm with Cigna right now and they're crying "PRE-EXISTING" so, I'm having to run through some hoops... They decline everything for days. It's almost to the point where my doctor has to get a pre-auth for me to go to the bathroom...

I found it very easy to qualify for Enbrel with United Healthcare... I had Enbrel fax my doctor the forms to fill out and send to my insurance company. Within a few days they said "okay" and I filled the prescription through Pharmacare in Chicago. They overnighted the medicine to me. Really easy. And it was only a $7 per month copay..
I'm with Cigna right now and they're crying "PRE-EXISTING" so, I'm having to run through some hoops... They decline everything for days. It's almost to the point where my doctor has to get a pre-auth for me to go to the bathroom...
Are you covered through your job?I believe then can no longer exclude pre-exisiting conditions.

There are rules such as that I have to have the disease for at least a year for it not to be considered "pre-existing." And I needed to send them a certificate of prior coverage from United Healthcare. So, they're not denying coverage. My doctor just needed to fill out some forms for the insurance company, which they claim to have happened, however Cigna still hasn't paid out any of my claims yet...
But they are being really strict with what I'm prescribed and what hoops I have to jump through to get my prescriptions approved. Topicals are the toughest. They denied a $28 prescription (a pound jar of ointment) because it was more than a 30-day supply. Still haven't got that one approved, so I just pay out-of-pocket.

Blue Cross here in Mass., no problems getting enbrel. Co-pay was $25 for a month's supply. Also,
I didn't have to get a GP's approval before I went to the derm and podietrist.

When I was on Enbrel I was also with United. I had a $50 a month co-pay. They approved it no problem (in fact, it was much harder to get my light box).

I'm on Blue Cross of Az. I have to pay 2250.00 every year before it's covered. I have a $1200.00 deductible and a $1000.00 out of pocket before they pick up the Enbrel. Also anyone comming up to a year on Enbrel has one hell of a fight to get it going into the second year. Linda

I have Perferred Care---an HMO out of Rochester, NY and just found out they don't cover Enbrel for psoriasis, but may cover it for pa. This seems strange. I also don't know if they will cover Humira either.
Sandy

I have an HMO through the State of Illinois, with Medco for scripts. I tried Enbrel - didn't work. I now use methotrexate and Humira - no problem with coverage for any of them - I pay $36.00/mo. no matter what the dose of Humira (which, by the way is FINALLY clearing my PPP!) - Kathy
p.s., Humira was just approved for p and PA in Europe last week, let's hope it is FDA approved here soon!!

Have never tried for Enbrel, used to have United HealthCare, never had a problem with them for anything (except for some of the bloodwork while on Soriatane, strangely they would pay for the tests but not the blood draw charge). My ex-employer now makes us use Cigna, who made me write a letter of appeal for Elidel.