Stelara $12,000 copay? How do I navigate a new insurance?

Frustrated today. After my first flare that lasted over a year and many medications tried, Stelara has finally seemed to do the trick. I have a colonoscopy in November to confirm remission!

I started a new job as a children’s librarian and the city only has one insurance option; Anthem. I previously worked at Starbucks for 5 years under Cigna which covered everythinggggggg so I was definitely spoiled.

I can’t get my script filled at the specialty pharmacy I usually pick up from because they said Carelon is my preferred pharmacy. Okay, whatever, kinda annoying because I don’t want delivery but I request my prescription be changed over to them.

Prior authorization is approved so I’m feelin real good. Call to schedule a refill. $12,000 copay they told me. I should sign up for the Stelara savings card because I can bring it down to just $5!! Except when I call they tell me the savings card only covers up to $9,000 annually.

I also thought that my copay would factor into my deductible/maximum out of pocket (which is $3,000) but the Carelon rep said that my copay would remain the same for each pick up so idk.

I don’t even MAKE $12,000 in 8 weeks. I’m guessing they want me to switch to a generic but the rep for Carelon wasn’t able to advise me so I’m waiting for a reply from my doctor.

In the meantime this has been a whole thing for weeks and I’m supposed to take my next dose on October 20th. I don’t think I could emotionally handle regressing lol so any advice would also be appreciated in how anyone else has navigated this or has Anthem while on Stelara.