How Much Rheumatoid Arthritis is Costing Me Out of Pocket

Cathee McKeown Health Guide
  • When I was first diagnosed with Rheumatoid Arthritis, the only pain that I could think of was the physical and emotional pain. I really couldn’t wrap my brain around all of the other “pains” that I would face when it came to the cost of treating a chronic illness. Before RA, I was a generally healthy person so I didn’t have to use my health insurance too often. I really had no idea how expensive treating a chronic illness would be. Even with insurance, between the cost of doctors’ visits, monthly lab work and medications, I was paying out $300-$500 month! I was also trying some alternative treatments that were not covered by insurance, like acupuncture which cost $75 a session 2-3 times per week.

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    My RA was so aggressive that I was on Social Security Permanent Disability within 2 years of being diagnosed. Once I was on permanent disability, I qualified for Medicare (for those of you not familiar with Medicare, you aren’t missing much). Even with Medicare and my individual health insurance plan, I still had difficulty in getting approval for certain medications. In the early days of Enbrel, Humira and Remicade, I had to fight my insurance company for approval to take these medications. Medicare didn’t provide any prescription coverage and since the meds were so new, they were very expensive. My insurance didn’t want to cover me unless I had tried literally every other treatment available and failed them. So, to the detriment of my health as well as my bank account, I tried…failed…tried…failed and failed again.

    I am still struggling with my healthcare even 10 years later. This past August, my Medicare Part B ran out. Since I was on Medicare when I joined my current health plan with Kaiser Permanente, I qualified for the Senior Advantage Plan. Which is kind of funny since I am only 37 years old. Anyway, I was never notified that my Part B had expired and therefore I no longer qualified for the plan at Kaiser. Since August I have been fighting to reinstate my Medicare Part B and re-join Kaiser again.

    As of right now, I have no coverage. This is the first time in my life that I have not had health insurance. It has made me realize how life- changing it can be to have an illness and no medical coverage. There are millions of people who are in this situation everyday. The cost of a doctors’ visit without insurance can easily run $150 per visit (depending on where you live). Prescription costs are through the roof. I have to take Nexium for acid reflux and a month’s worth of pills is $135. The cost for Remicade (which is what I was taking before my insurance was canceled) is in the thousands for just one infusion.

    How do people afford this? Healthcare is something I never really thought of in my day-to-day life before being diagnosed with Rheumatoid Arthritis. Since being sick, there hasn’t been a day that I haven’t thought about it. Even with insurance the costs can add up quickly. When my Medicare initially ran out, I asked Kaiser if I could reapply as an individual so I could continue with my current doctors and treatments. Of course, they said that I would have to be reevaluated and have a medical review. Basically, they said that since I have a pre-existing condition I would be denied. The only way that I can continue with them is to get my Medicare Part B reinstated (easier said than done!) or join through my husbands’ plan through his work.


  • So, here I am… 5 months without insurance, no medications and no check-ups with my doctors. It has been devastating. I worry every day about how I am going to pay for everything. Being in this situation has made me realize how many others must live this way. In a country that has so much money and opportunity, it is truly shameful that so many people can’t get their basic healthcare needs taken care of. I am lucky that I have a supportive husband who makes a good living and family that can help. There are a lot of people who do not have any options outside of government aid. Finding access to affordable healthcare is a problem that seems to be getting worse, not better.

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    • Have you had trouble with healthcare costs? Share your story by leaving a comment below or posting it on the Message Boards.



Published On: December 12, 2006