Does Insurance Cover Ubrelvy?

Does Insurance Cover Ubrelvy?
Health Insurance claim form and stethoscope on desk

Does Insurance Cover Ubrelvy?

Abbrelvy, a prescription medication used to alleviate pain and symptoms at the onset of a migraine episode, contains ubrogepant as its active ingredient. Ubrogepant influences inflammation, pain transmission, and blood vessel dilation, all contributing factors to migraine symptoms. While adverse effects from Abbrelvy are rare, its main drawback is its price. Without a generic equivalent available, individuals without insurance may face the full retail cost of the prescription unless they employ certain money-saving strategies.

Is there a generic version of Abbrelvy?

No, there is currently no generic version of Abbrelvy containing the active ingredient ubrogepant. It is not anticipated to have a generic alternative until at least 2035.

Does insurance cover Abbrelvy?

Certain Medicare Part D plans and health insurance policies do cover Abbrelvy, but coverage varies. Before obtaining a prescription, it’s advisable to confirm coverage with the insurance provider, as Medicaid coverage may also differ between states. Some insurance plans may require prior authorization before covering Abbrelvy. Additionally, since Abbrelvy may be listed at the highest copay levels in insurance formularies, out-of-pocket expenses could be significant. Patients with commercial insurance may be able to reduce copays by using an AbbVie copay card.

How much does Abbrelvy cost without insurance?

For individuals without health insurance, a 100 mg oral Abbrelvy tablet could cost around $1,300, with each tablet typically priced at $130. Typically, individuals experiencing the onset of a migraine episode take one 50- or 100-mg tablet to alleviate symptoms, potentially requiring a second tablet if the first is ineffective. Thus, the average cost per migraine episode can range from $130 to $260.

For those without insurance seeking alternative migraine treatments, options are limited. Except for Nurtec (rimegepant), all medications within the same class as Abbrelvy, known as calcitonin gene-related peptide receptor antagonists (CGRP inhibitors), are FDA-approved only for migraine prevention, not treatment. Nurtec, priced similarly to Abbrelvy, offers another option. Alternatively, there are other migraine therapy solutions such as triptans, ergot medications, or nonsteroidal anti-inflammatory drugs (NSAIDs), which differ in efficacy, side effects, and interactions compared to Abbrelvy.

Using a SingleCare prescription discount card is a recommended method for saving money on Abbrelvy prescriptions. At pharmacies accepting SingleCare, the discounted price for ten 100-mg Abbrelvy tablets can be as low as $885, more than $400 less than the typical retail cost.

How to get Ubrelvy without insurance

Treating a single migraine headache with Ubrelvy will cost between $130 and $260 at full retail price, as each pill costs $130.

Paying for Ubrelvy without health insurance may pose challenges, as assistance from the Allergan patient assistance program is only available to those meeting stringent eligibility criteria. However, there are additional methods to reduce Ubrelvy costs, with the SingleCare savings program being a beneficial option.

SingleCare’s savings card could decrease the cost of each pill from $130 to $85, offering significant savings. Utilizing a free coupon from SingleCare may save individuals up to $420 off the typical retail price of ten Ubrelvy tablets.

For those unable to meet income requirements, exploring eligibility and enrollment procedures on their state’s Medicaid website is advisable. Similarly, the Medicare Low-Income Subsidy can provide assistance for individuals unable to afford Medicare Part D medication coverage, subject to specific criteria. It is essential to confirm whether Ubrelvy is covered in one’s state.

Considering generic medications for migraines, such as NSAIDs, ergot pharmaceuticals, or triptans, may also be necessary. Over-the-counter NSAIDs could be effective, but consulting with a healthcare provider regarding alternative medications is recommended.

Understanding factors such as Ubrelvy’s presence in the plan’s formulary, the need for prior authorization, tier placement, and cost-sharing responsibilities is crucial in assessing insurance coverage. Discussing coverage options with a healthcare practitioner and evaluating insurance policies thoroughly can aid in making informed decisions about managing migraine episodes.

Medication coverage plays a vital role in healthcare, aiming to provide affordable access to effective treatments for various medical conditions. Timely access to medications like Ubrelvy can significantly improve the quality of life for individuals suffering from chronic and debilitating migraines. Encouraging transparency and collaboration with healthcare professionals, insurance companies can ensure that medically necessary therapies are readily available to those in need.

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