Will health insurance cover Aubagio?
Are you wondering if your health insurance will cover Aubagio? This article explores the topic, providing insights and information about the coverage of this medication. Discover what you need to know about health insurance and Aubagio.
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Dani Best
Licensed Insurance Producer
Dani Best has been a licensed insurance producer for nearly 10 years. Dani began her insurance career in a sales role with State Farm in 2014. During her time in sales, she graduated with her Bachelors in Psychology from Capella University and is currently earning her Masters in Marriage and Family Therapy. Since 2014, Dani has held and maintains licenses in Life, Disability, Property, and Casualt...
Licensed Insurance Producer
UPDATED: Nov 28, 2023
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UPDATED: Nov 28, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.
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In the world of prescription medications, it is essential to understand the coverage provided by your health insurance. One such medication is Aubagio, which is prescribed for the treatment of multiple sclerosis. If you are considering starting this medication, it is crucial to know whether your health insurance will cover the cost. This article aims to provide you with an overview of Aubagio, explore its cost, and dive into the intricacies of health insurance coverage for this medication. So, let’s get started on understanding if health insurance will cover Aubagio.
Understanding Aubagio: An Overview
Aubagio is a prescription medication used for the treatment of relapsing forms of multiple sclerosis. Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, specifically the brain and spinal cord. It is characterized by inflammation, damage to the protective covering of nerve fibers, and the formation of scar tissue.
MS is believed to occur when the immune system mistakenly attacks the myelin, which is the fatty substance that surrounds and insulates nerve fibers, disrupting the normal flow of electrical impulses along the nerves. This can lead to a wide range of symptoms, including fatigue, difficulty walking, muscle weakness, numbness or tingling, problems with coordination and balance, and cognitive impairment.
Aubagio belongs to a class of drugs known as disease-modifying agents. These medications are designed to alter the course of the disease by targeting specific aspects of the immune system. In the case of Aubagio, it works by reducing the number of immune cells that cause inflammation in the central nervous system.
How Does Aubagio Work?
Aubagio contains the active ingredient teriflunomide, which inhibits the enzyme responsible for the production of specific immune cells. This enzyme, known as dihydroorotate dehydrogenase, plays a crucial role in the synthesis of DNA and RNA, which are essential for the replication and function of immune cells.
By limiting the number of these immune cells, Aubagio helps to control the inflammation in the central nervous system, thereby reducing the symptoms and progression of multiple sclerosis. It is important to note that Aubagio does not cure multiple sclerosis, but it can help to slow down the progression of the disease and reduce the frequency of relapses.
Aubagio is available in tablet form and is typically taken once a day. The dosage may vary depending on the individual’s condition and response to treatment. It is important to follow the prescribed dosage and schedule provided by a healthcare professional.
Like any medication, Aubagio may cause side effects. Common side effects include diarrhea, nausea, hair thinning or loss, and elevated liver enzymes. It is important to discuss any concerns or potential side effects with a healthcare professional.
In conclusion, Aubagio is a disease-modifying agent used for the treatment of relapsing forms of multiple sclerosis. By reducing the number of immune cells that cause inflammation in the central nervous system, Aubagio helps to slow down the progression of the disease and reduce the frequency of relapses. It is important to work closely with a healthcare professional to determine the appropriate treatment plan for managing multiple sclerosis.
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The Cost of Aubagio
When considering a medication like Aubagio, it is essential to be aware of the associated costs. The retail price of Aubagio can vary depending on various factors, including the dosage strength prescribed and the pharmacy you choose. It is advisable to consult with your healthcare provider and pharmacist for specific pricing details in your area.
Retail Price of Aubagio
The retail price of Aubagio can range from per month. This price can be a significant financial burden, especially considering that multiple sclerosis is a chronic condition that requires long-term treatment. However, the actual cost you will pay may differ based on your health insurance coverage.
Factors Influencing the Cost of Aubagio
Several factors can influence the cost of Aubagio, including your health insurance plan’s coverage policies, co-payments, deductibles, and any available discounts or financial assistance programs. These variables can significantly impact the out-of-pocket cost you may incur for this medication.
Health Insurance and Prescription Medication Coverage
Understanding how health insurance covers prescription medications is crucial when determining if Aubagio will be covered. Health insurance plans vary, and coverage for medications can differ significantly from one plan to another. Here, we will explore the general principles of health insurance coverage for prescription medications.
How Health Insurance Covers Prescription Medications
Health insurance plans typically categorize prescription medications into different tiers or formularies. These tiers classify medications based on their cost, with lower tiers representing generic or preferred brand-name drugs and higher tiers reserved for non-preferred brand-name medications or specialty drugs like Aubagio.
Most health insurance plans require you to pay a portion of the medication cost, usually in the form of a copayment or coinsurance. Copayments are fixed amounts you pay for each prescription, while coinsurance represents a percentage of the medication cost you are responsible for. It is important to consult your health insurance plan’s details to understand your specific coverage terms.
Variations in Coverage Across Different Insurance Providers
Health insurance providers have their own coverage policies and formulary lists. Therefore, Aubagio coverage and associated costs can vary depending on the insurance company you are enrolled in. Some insurance providers may list Aubagio as a preferred medication, resulting in lower out-of-pocket expenses, while others may place it in a higher tier, potentially leading to higher costs.
Checking Your Insurance Policy for Aubagio Coverage
To determine if your health insurance covers Aubagio, carefully review your insurance policy documents or contact the insurance company directly. Look for information on prescription medication coverage, formularies, and any specific mention of Aubagio. Pay close attention to any restrictions, prior authorization requirements, or step therapy protocols that may apply.
Contacting Your Insurance Provider for Confirmation
If the information provided in your insurance policy is unclear or if you have additional questions or concerns, it is advisable to contact your insurance provider’s customer service department. Speaking with a representative can help clarify your coverage, including specific details about Aubagio and any out-of-pocket costs you may face.
What If Your Insurance Doesn’t Cover Aubagio?
If your health insurance does not cover Aubagio or if the associated costs are prohibitive, there may still be alternative payment options available to you.
Alternative Payment Options for Aubagio
Pharmaceutical companies often offer patient assistance programs and savings cards that can help reduce the cost of medication. These programs may provide financial support or discounts to eligible patients, making Aubagio more affordable. Additionally, exploring generic or alternative medications with your healthcare provider may present more cost-effective options.
Patient Assistance Programs for Aubagio
Abbvie, the manufacturer of Aubagio, offers a patient assistance program called , which aims to provide financial support to individuals who meet specific eligibility criteria. This program may offer free or discounted Aubagio to qualified patients, easing the burden of medication costs. Contacting Abbvie or visiting their website can provide you with further information on program requirements and how to apply.
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In Conclusion
Considering the costs associated with Aubagio and the potential impact on your finances, it is essential to understand if your health insurance will cover this medication. By familiarizing yourself with the coverage policies of your insurance provider and exploring alternative payment options, you can make informed decisions regarding your multiple sclerosis treatment. Remember to consult with your healthcare provider and insurance company to ensure you have accurate and up-to-date information that will guide you towards the most suitable options for your specific situation.
Frequently Asked Questions
Will health insurance cover the cost of Aubagio?
Health insurance coverage for Aubagio may vary depending on your specific insurance plan. It is recommended to contact your insurance provider to determine if Aubagio is covered under your policy.
What is Aubagio?
Aubagio is a medication used to treat relapsing forms of multiple sclerosis (MS). It works by reducing inflammation in the central nervous system.
How does Aubagio work?
Aubagio works by inhibiting the immune cells that contribute to the inflammation seen in multiple sclerosis. By reducing inflammation, it helps to slow down the progression of the disease.
What are the side effects of Aubagio?
Common side effects of Aubagio include diarrhea, nausea, hair loss, abnormal liver function tests, and numbness or tingling in the extremities. It is important to discuss any side effects with your healthcare provider.
Is Aubagio effective in treating multiple sclerosis?
Aubagio has been shown to be effective in reducing relapses and slowing down the progression of multiple sclerosis. However, its effectiveness may vary from person to person. It is best to consult with your healthcare provider to determine if Aubagio is the right treatment option for you.
Can I take Aubagio if I don’t have health insurance?
Aubagio can be quite expensive without health insurance coverage. If you don’t have insurance, it is recommended to explore other options such as patient assistance programs or discussing with your healthcare provider about alternative medications that may be more affordable.
Compare The Best Insurance Quotes In The Country
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Dani Best
Licensed Insurance Producer
Dani Best has been a licensed insurance producer for nearly 10 years. Dani began her insurance career in a sales role with State Farm in 2014. During her time in sales, she graduated with her Bachelors in Psychology from Capella University and is currently earning her Masters in Marriage and Family Therapy. Since 2014, Dani has held and maintains licenses in Life, Disability, Property, and Casualt...
Licensed Insurance Producer
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.