Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

AbbVie Patient Assistance Program Foundation for HUMIRA

This program provides brand name medications at no or low cost

Provided by: AbbVie

D-617927, AP5 NE
1 N. Waukegan Rd.
North Chicago, IL 60064

TEL: 800-222-6885


FAX: 866-250-2803
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Patient Assistance Applications

AbbVie Patient Assistance Foundation Application for HUMIRA

AbbVie Patient Assistance Foundation Application for HUMIRA (Spanish)

 

Brand Name Medications Covered

 
  • Humira injection
 

Generic Name

 
  • adalimumab injection
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage for needed medication
Those with Part D Eligible? Considered on exception basis
Income Not disclosed
Diagnosis/Medical Criteria Open to all diagnoses
US Residency Required? Must be treated by US Doctor
   

Application

Obtaining Call
Receiving Faxed or mailed
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach proof of income and any insurance information
Decision Communicated Patient and Doctor notified of acceptance
Decision Timeframe Within 24-48 hours
   

Medication

Amount/Supply Up to 90 day supply
Sent To Doctor's office or patient's home
Delivery Time Within 3-5 business days
Refill Process Patient or Doctor must contact company
Limit Not specified
Re-application New application, new documentation yearly
   

Additional Information

Patients with prescription drug coverage may be eligible on exception basis.


Updated July 12, 2017