Does Aetna cover Humira?

In this article:

• Does Aetna cover Humira?
• How much does Humira cost?
• How much does Humira cost with Aetna?
• How to check whether your Aetna plan covers Humira
• What to do if insurance won’t cover Humira
• Alternatives if Aetna doesn't cover Humira
• How to get Humira without insurance

In this article

• Does Aetna cover Humira?
• How much does Humira cost?
• How much does Humira cost with Aetna?
• How to check whether your Aetna plan covers Humira
• What to do if insurance won’t cover Humira
• Alternatives if Aetna doesn't cover Humira
• How to get Humira without insurance

If you are living with an autoimmune condition, your healthcare provider may prescribe Humira (adalimumab). Humira is approved by the Food and Drug Administration (FDA) to treat conditions such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriatic arthritis, ankylosing spondylitis, uveitis, and juvenile idiopathic arthritis (JIA). As a complex biologic drug, it is very expensive to make, and that cost is passed down to consumers. There are several biosimilar versions available, which may be more affordable options than brand-name versions. If you have insurance through Aetna, your plan may not cover brand-name Humira, but may be more likely to cover a biosimilar.  

Does Aetna cover Humira?

​​As of April 1, 2024, most Aetna formularies no longer cover brand-name Humira. With these changes, though, members will typically have access to a selection of biosimilar adalimumab products that are lower-cost alternatives, such as Cyltezo (adalimumab-adbm), Yusimry (adalimumab-aqvh), and Hulio (adalimumab-fkjp). Some healthcare providers may recommend completely different alternatives, depending on the condition being treated. 

“Methotrexate is our first-line treatment for rheumatoid arthritis,” says Francesca Okoye, MD, a board-certified rheumatologist with Rheumatology at Mercy Medical Center in Baltimore, Maryland. “I prescribe Humira for patients who have failed to improve on methotrexate or who have not tolerated it. Or I would prescribe Humira for people who have other medical conditions and who cannot take methotrexate.”

Insurance coverage can be complicated, and every health plan is different. The best way to confirm whether your Humira will be covered or not is to check your insurance plan’s formulary, which is a list of drugs that an insurance company covers.

In many instances, prior authorization may be required for certain medications. This is when a healthcare provider coordinates with the insurance company to ensure that a prescribed medicine or treatment is medically necessary.

How much does Humira cost?

Humira costs vary by pharmacy, but without insurance or discounts, you can expect to pay the average retail price of $8,887 for a one-month supply of two brand-name Humira subcutaneous autoinjectors. This drug’s high cost is due to its complex production process and use of DNA technology. Note that prices vary depending on the dosage, quantity, and pharmacy. 

How much does Humira cost with Aetna?

If you have an Aetna insurance plan, what you pay out of pocket for your prescription will depend on the specifics of your plan. Since Humira is a specialty drug, it is likely to be on the highest drug tier, meaning the most expensive copay. Different Aetna plans may charge different amounts for Humira (or a biosimilar). For example, if you have an Aetna Medicare Part D plan, you may pay $0–$2,100 per month, depending on which coverage phase you’re in, according to its manufacturer, AbbVie.  

How to check whether your Aetna plan covers Humira

There are a number of ways to find out if your Humira will be covered by Aetna:

• Call Aetna directly and ask to be connected with someone who could provide detailed information about coverage for Humira. Check whether your member ID card has a phone number for pharmacy benefits.
• Try logging into your Aetna account online. You may be able to search the formulary for certain medications like Humira to see if your specific plan covers it and, if it does, how much it will cost.

What to do if insurance won’t cover Humira

If your Aetna plan denies your prescription for brand-name Humira, you can ask your healthcare provider about a prior authorization. Specialty medications like Humira usually require pre-approval from your insurance. 

If your Aetna plan denies the prior authorization request, your healthcare professional can appeal the decision by submitting additional clinical information. If the appeal is then denied, you can explore discount programs, such as SingleCare, as well as savings options from AbbVie. You can also talk with your healthcare provider about trying a Humira biosimilar or look into other Humira alternatives. 

What alternatives are there if Humira is not covered by my insurance?

“Your insurance company may pay for a drug that is a biosimilar to Humira,” Dr. Okoye says. A biosimilar is similar to a generic but made to be very similar to a biologic drug. Various biosimilars have been FDA approved for Humira:  

• Amjevita (adalimumab-atto)
• Cyltezo (adalimumab-adbm)
• Hyrimoz (adalimumab-adaz)
• Hadlima (adalimumab-bwwd)
• Abrilada (adalimumab-afzb)
• Hulio (adalimumab-fkjp)
• Yusimry (adalimumab-aqvh)
• Idacio (adalimumab-aacf)
• Yuflyma (adalimumab-aaty)
• Simlandi (adalimumab-ryvk)

“In addition to Humira biosimilars, there are four other TNF-alpha inhibitors that may be covered by insurance,” Dr. Okoye says. These include Enbrel (etanercept), Cimzia (certolizumab pegol), Simponi (golimumab), and Remicade (infliximab). Your healthcare provider can determine which specific medication is best for your needs.

RELATED: Humira alternatives

How to get Humira without insurance

There are several ways to save on Humira. For example, a SingleCare prescription discount card provides access to Humira coupons you can use at over 35,000 participating pharmacies across the country. With a Humira coupon from SingleCare, you could save almost $3,000 each month for brand-name Humira. You can also talk to your healthcare provider about biosimilars. If you use a biosimilar and apply a SingleCare discount, you can save even more. For example, the biosimilar Hadlima costs an average of $1,391 for a one-month supply, and you can use a SingleCare coupon for Humira to pay as low as $1,017 per month.

You can also talk to your healthcare provider or pharmacist, who may be aware of other ways to reduce your costs.

The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of March 30, 2026. Prices vary by pharmacy. Visit our Humira coupon page for updated Humira prices near you.