How to Manage Insurance Costs to Treat Your Psoriasis

Woman showing nurse psoriasis on her hand
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It is an exciting time in the treatment of psoriasis and psoriatic arthritis with numerous new treatment options available to target this chronic condition in different ways. Many people can now aim to be clear or almost clear of skin disease or back in the action with their joint pain well controlled on new therapies. While this is certainly exciting news, many of these new treatments are extremely expensive, with cash prices ranging as high as $20-30,000 per year to treat one person.

That said, it is important not to lose hope and to work with your doctor to find a treatment that is not only going to help you, but also work with your budget.

Remember that almost no one pays the full cash price for these medications — very few could afford to! For many patients their insurance will pay a portion of the cost. Your insurer may require that you choose medications from a list of pre-approved medications (called a formulary). Usually your insurer has negotiated a lower price on these medications with the pharmaceutical manufacturer. Often insurers will also insist that you have tried and failed to see results with a less expensive, older medication, like methotrexate (called step therapy) before they will pay for new or more expensive drugs. You may also have to pay a portion of the treatment cost in co-pays or by meeting your annual deductible. If you or your employer are considering changing insurance companies, make sure you shop around for which coverage will be best with your medications.

For individual (“Obamacare”) plans, check with a list of your medications.

Insurance, although important, is only part of the consideration. Many manufacturers of name-brand medications have programs to reduce co-pays or deductibles for insured patients. Check with the manufacturer of your medicine to see if they offer such programs or coupons.

Another option may be to consider a generic alternative to an older medication. While not all generics are inexpensive, some (like topical steroid creams) are often much cheaper than their name-brand counterparts.

If you have a federally-backed insurance (like Medicare, Medicaid, or Tricare) these coupons or cost-reduction programs are often not available due to conflicts with federal regulations. Check with the manufacturer to see if they have any special programs for these situations. Consulting your plan’s formulary before you visit the doctor can help. An even better strategy would be to print out the medications listed under skin or psoriasis treatments and bring them with you to your visit.

Perhaps you have no insurance or medication coverage at all. Even in this situation, there is still hope. Many manufacturers offer foundations which provide free or low-cost medication if you fall below certain income parameters. The Affordable Care Act means that you can apply for insurance and subsidies to help pay for treatment and you cannot be turned down because of pre-existing illness.

Getting proper (and sometimes expensive) treatment for your psoriasis can make a world of difference in your life. It is critically important to be your own advocate, to follow up with your doctor, and to not give up when trying to get your treatment covered. It is a valuable investment of your time that can pay off with years of improved health.

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