Jetted, I have added you to my team if that is okay! I also have the Medicare Advantage plan. I use Humira and Abbvie helps with cost. I’m so thankful for it.

Thanks all for your helpful answers. It seems that infusion is the better option cost- wise but one 'size' doesn't fit all. Each person's RA is unique.

Medicare part B pays for infusions but not home administration of injections. It limits your options if you don't have a work sponsored Rx plan. I have the N supplement and Medicare part D. My monthly out of pocket for Embrel - which does not have an infusion and is one of the most used biologics, would be $500 and would need prior authorization. They have granted my prior authorizations so are good about that. There is a cap on what you pay, a donut hole and then catastrophic coverage so it might not be 6K per year out of pocket. Biden got through a change that will go into effect 2026 to limit prescriptions to around 2K. My rheumatologist went directly to infusion because I am on Medicare. I am on Orencia infusions. I pay $268 deductible yearly and $20 co-pay for doc appointments. There is no additional charge for Orencia. It's about $3500 a month completely covered. If you go with traditional Medicare you also can pick your docs. That's not an option to my knowledge with Advantage programs. Hope that helps.

Certain drugs are injections, others are infusions. Some are both. Patient does not usually decide.

@A myRAteam Member. Yes my Medicare advantage does cover dental and vision. I’m not sure as I’m new to it, but it depends on your carrier I think. I use United Healthcare and so far so good.

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