I know how expensive it can be to have a chronic illness such as Psoriatic Arthritis. My husband and I frequently joke that when he married me he knew I was high maintenance, but after my diagnosis I became 'Ultra High Maintenance.' Here are some tips to keep in mind when working to manage the cost of Psoriatic Arthritis.
How Insurance Can Help
For most patients, health insurance is the most often used tools for managing costs. I am fortunate to have affordable coverage through my husband’s employer. For me, this is essential, as one of my medications costs $20,000.00 per dose. Since I go for treatments in my rheumatologist’s office, my copay is only $55 for the office visit, and I pay no additional fee for my medication.
My first rheumatologist sold his infusion practice to a local hospital and all his patients were transferred there for our infusions. Was I ever surprised to receive a hospital bill for $2,000.00 for one infusion! That being said, here's another thing to keep in mind if you undergo infusion treatments: It matters to your insurance company where you infuse.
After receiving that bill from the hospital, I learned about www.ToInfuse.com. This is a website listing physicians, hospitals and infusion centers where you can receive your infusion medication. From there, I cross referenced the doctor’s offices with my insurance providers and found a new rheumatologist right away. I never did use an infusion center, so I do not know what my cost might be there.
Additionally, with my disease, most of my physicians are specialists, so under my insurance visits are all $55.00 each. My primary care physician copay is only $35.00 per visit, and prescription copays range from $10.00 to $40.00 each. Outlining these insurance rates can help us plan and manage costs.
Managing Outside Costs
Even with this coverage, my husband and I typically spend $3,000.00 per year on out-of-pocket medical expenses just for me. One way we manage this cost is by using our employers’ cafeteria plans, and put this amount aside pre-tax to use throughout the year. There are legal limits on how much you can put on your plan every year and it can be tough to estimate what you need at the beginning of the year - but we feel it is worthwhile. We also use our Health Savings Account to cover copays, prescriptions, surgeries and eyeglasses.
Managing Costs Without Insurance
I have always had health insurance, but if I didn’t, there would still be ways for me to manage the cost of my Psoriatic Arthritis:
First, I might speak to my doctors about the most cost-efficient treatment plan and best way to afford my appointments. You never know what they are willing to arrange for you if you do not ask. Second, I might** create a health expense budget** to help me find as many dollars as I can for medical expenses each month. There is lots of information about this online.
Even if you do not have health insurance through your employer, you can still take advantage of a pre-tax Health Savings Account, if it is offered. I do not take the health insurance at my firm because my husband’s is less expensive, but I do use the cafeteria plan at my firm.
There are many other resources available to patients to help them manage costs. There is a comprehensive list on the National Psoriasis Foundation site that can help with your search. Perhaps you qualify for assistance with your biologic medication, other medications and treatments, including home phototherapy, help from the state you live in, or help with copays or Medicare.
"The bottom line is, do not forego treatment if you do not have health insurance. There is lots of help available. You will never know if you qualify unless you inquire. Psoriatic disease can lead to joint and organ damage if untreated. I think you are worth it."
I hope your find these tips helpful and that they have encouraged you to find a way to manage your care with the tools above. Until next time.