Humira medication not covered after March 31

If you or a family member take the medication Humira (adalimumab) and you’re on a Regence BlueShield medical plan, please note the following coverage change.

Starting April 1, 2024, Humira will no longer be covered for those on the Regence KingCare PPO and KingCare Select medical plans.

CVS Caremark®, the pharmacy benefits manager for Regence BlueShield, has mailed letters to inform impacted members that the biologic drug, Humira, will be removed from the list of covered medications and replaced with biosimilar medications. A list of covered alternate medications specific to the member’s condition was also provided with the CVS letter. In addition, CVS has notified health care providers who prescribe Humira to their patients.

If you take Humira, it is imperative that you talk with your doctor and discuss options that are right for you. If you fill a prescription for Humira after April 1, 2024, it will not be covered and you will have to pay the entire cost. If you can’t use a covered alternate medication for a medical reason, your doctor can request a medical necessity review through CVS.

If you have questions, please call CVS Caremark at 844-380-8838.