If you do look for your own insurance, not sure what your jobs/career is, but I've found the best health insurances I've had were when I worked in hospitals. And my family often met the out of pocket maximum so it worked well enough. Back when I was still on my parents insurance, one year they were able to switch to a plan that wasn't worse for the rest of them, but was better coverage for me. If you're still on your parents plan, still look into the out of pocket maximums and you can still call, as a covered member even though you aren't the guarantor. My best advice would be to try and find an insurance plan next year that covers Aimovig at a more affordable cost, if that's an option for you. And the excessive prescription drug costs in the US contribute to high patient costs. Might not change much in the short term, but could be therapeutic. You could try writing to your elected officials with your story. I realize this isn't all that helpful because it's the result of an insurance system that is focused on profit instead of what's best for patients. Often, when you use a copay program (like Aimovig Ally or GoodRx) along with your insurance, the extra amount they cover (like the $200) also contributes to your OOP max, because it was the amount insurance billed to you (even though you got a third party to cover part of it). Sometimes there is a separate OOP max for out of network covered costs, so definitely double check so you can put as many medical costs as possible in the OOP max bucket that you can meet sooner. If you have other family members that have high medical costs, it may help you reach the family OOP max sooner. Sometimes there is a family OOP max for your plan, which may be higher than an individual OOP max. The deductible usually contributes to your OOP max, as do your doctor's visits and other medical expenses for your plan. It's often a few thousand dollars (could be more for high deductible plans), which is still high, but it is an upper limit that you can budget for, especially if you have other medical expenses that contribute to it. This is an affordable care act (ACA) measure so all ACA compliant insurance plans will have one. Once you reach this amount, all covered medical expenses will be covered at 100% (so $0 to you). ![]() Your plan out of pocket maximum (OOP max) is the most you will pay in a given insurance plan year for covered medical expenses. ![]() do you have a prescription deductable? what is your prescription deductible? Is it combined with your other medical deductible or is it separate only for prescriptions? ![]() You should also look into your prescription benefits a bit more, and be able to answer questions like: You would need to call your insurance company or dig through their online portal to find out. However, because your insurance does cover Aimovig, just not well, there will be a maximum amount you owe for the insurance plan year. The Amgen Safety Net Foundation was the only active one I found for Aimovig, and as you mentioned, it has very specific eligibility criteria. There are some patient copay assistance programs for migraine that are currently closed but you could contact them to see if they plan to re-fund them in the future ( or are two). Tl dr: there aren't any current patient assistance programs specifically for migraine or Aimovig except for the Amgen Safety Net Foundation. My insurance excluded Aimovig starting in January and I went on a deep research dive to try and find a way to pay for it. Hi! I'm sorry you're in this insurance nightmare.
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