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you definitely need a new rheumatologist - unless you are actively trying to conceive, limiting you to one medication doesn't make a lot of sense. Methotrexate does cause severe birth defects, so it's important that you do everything you can to not get pregnant when you're on that, but I haven't heard this concern preventing treatment before.   Both you and the person asked the question may benefit from reading Lisa Emrich's latest post about financial support for medications and you may also want to check out one of my recent posts on SSD, in case that's applicable to you.   I'm Canadian, so I don't know the ins and outs of the American healthcare system, but isn't there some way you can get a doctor without paying for it?  I vaguely recall someone mentioning your local health department as a possible source.   Good luck!