Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

United Healthcare Insurance

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Does anyone have experience with United Healthcare Insurance Company? I understand they consider once a day HIV regimens a specialty medicine. Would like to know what kind of copays they have. Apparently they use OptumRX for specialty medications.

I've only had blue cross in the past and that was before I started hiv treatment. I'm receiving medicine through ADAP right now and am a little nervous about not being able to afford my medicine .

I am on a United Healthcare plan through my employer. I take Striblid and, yes I have to order through OptumRx. This is a recent change. Prior to July 1, I could use the Walgreen's Specialty located in the same building as my physician.  OptumRx is hit or miss service wise.  At times it is almost like dealing with an off shore call center.

My copay is $60 per 30 day supply. OptumRx does not provide 90 day refills. In their favor, they do accept my Gilead co-pay card which covers the entire co-pay making my out of pocket cost $0.

Please note that this is all dependent on which UHC plan in which you are enrolled. Your mileage my vary.

Thanks for your reply. I read that my copay through optumrx will be a maximum of $100 per 30 day supply. I think atripla will assist up to $1200 per year so it should work out OK. Now to worry about my doctor visits and lab work copays.

Like piscina said you should apply for the Gilead Co-Pay assist card. You will pay nothing out of pocket they cover I believe upto 240 a month. Just have to register for it pretty simple. Atripla, Complera and Stribild all use the Gilead card.

I too have United Healthcare through employer and I get to go to the pharmacy of my choosing. I guess it depends what the employer chooses. My copay is $40 but the copay assist card wipes that out.

Probably a dumb question but is there a certain income level where co-pay assistance is not available?


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