9 Tips and Tricks for Handling Psoriasis-Related Medical Costs
When you have a chronic condition like psoriasis, all the doctor visits, topicals, and other prescription medications can get pricey. In fact, the cost of psoriasis care equals about $135 billion dollars in the U.S. each year, according to the National Psoriasis Foundation.
The good news? There are certain steps you can take to help keep your out-of-pocket costs down. Start with these tips.
1. Find an In-Network Doctor Who'll Go the Extra Mile
Every health insurance plan works slightly differently. But chances are, your insurance company has a list of providers that are considered to be “in network” for your plan—meaning the doctor accepts your insurance and has agreed to provide service at a negotiated cost. However, if your doctor is “out of network,” it means they don’t have an agreement with your insurance company, and therefore the charges you incur for the care they provide can vary—which can make out-of-pocket expense more costly.
“I definitely use an in-network doctor,” says Howard Chang, a psoriasis patient advocate who has been living with the condition for more than 40 years. “When I had to change health plans, I looked for an in-network dermatologist that knows how to treat psoriasis specifically. It does save a lot of money if you can get in-network care.”
Plus, a specialist who knows you and what you need to achieve clear skin may go the extra mile to make sure your treatments are covered. “You need to have a doctor that will follow through,” recommends Chang. “There are a lot of good medications out there, but if costs are prohibitive, even though the medication is right for you, you need to have a doctor that fights for you.” Chang is referring to certain clinics, like the one he goes to, that provide access to a dedicated specialist who knows how to work with insurance companies to ensure patients have access to the treatment they need.
2. Don’t Skip Your Regular Checkups
Attending regular appointments can help you stay on top of both your psoriasis and your overall health. That can help you address potential health issues before they become a larger (and more costly) burden. “I usually see my dermatologist every two months, depending on the severity of my condition [at the time],” says Chang. “I’ve had urgent situations, but because I see my doctor regularly, and we use the clinic’s secure online messaging system where I can send pictures, my doctors have been super-responsive and have even squeezed me in for an appointment, if needed.”
3. Buy OTC Products in Bulk
Even if you’re able to manage your psoriasis with over-the-counter topicals, costs for these moisturizers and lotions can add up. “I shop at Costco or other big-box stores. I find sales and buy them in bulk,” says Chang. “It saves a little bit of money, which adds up over time.”
4. Understand Your Prescription Drug Coverage
If you do need prescription medications to help you manage your psoriasis, make sure you’re aware of your insurance plan’s drug coverage—know what the estimated costs are for each medication you take, and what your deductible is, advises Morgan Sayler Herring, Pharm.D., Board-Certified Pharmacotherapy Specialist and clinical associate professor at the University of Iowa College of Pharmacy in Iowa City.
Be especially diligent during your insurance re-enrollment period. “Reach out and talk to your insurance company about what the estimated costs are going to be for any drugs you take,” says Herring. “Formularies, or the lists of prescription drugs covered by a plan, change, and I hate having to switch patients’ medication for that reason only, especially if they’ve been on a medication for a long time.”
5. Open an HSA
“If you know you have very expensive medications, you [may be able to] place pre-tax money into a health savings account, or HSA, which ultimately saves you a little bit of money,” says Herring. See if your employer or health plan offers this benefit. If so, you may also be able to use the money you put into it to pay for other medical expenses related to your psoriasis care, like deductibles and co-pays.
6. Consider a Mail-Order Pharmacy
Compare prices between your current pharmacy and a mail-order one. “When it comes to pills and ointments, getting a 90-day supply through the mail-order pharmacy tends to be less expensive than if I go to the local pharmacy every 30 days,” says Chang. Plus, it’s convenient to have your medication shipped to your door instead of having to go pick them up. Mail order options often allow you to sign up for alerts or automatic refills so you don’t have to remember to take action when you’re almost out. If you go this route, stay on top of any changes—including treatment changes, as well as address changes—so there are no issues with getting the medications you need when you need them.
7. Look for Drug Coupons and Discounts
If you’re taking a particularly costly medication, like a biologic, you may be able to go to the drug company’s website and sign up for a savings program—even if you have insurance coverage. “If you’re on private insurance, sometimes there are coupons or discount savings plans you can sign up for to help cut your co-pay,” says Herring. “Though, if you’re on Medicare, which doesn’t really let you do these discount plans, the drug companies often have income-associated discount opportunities or other patient assistance programs you can sign up for.”
Your doctor may also contact the drug manufacturer directly on your behalf to help you get the medication you need at a price you can afford. “My doctor appealed to the manufacturer for one of my drugs, and as long as I had the right diagnosis, the prescription, and the rejection letter from my insurance company, they took that information and gave me the medication for free,” says Chang. “These companies want to get their medications out there, so if you’re the right candidate for it, with your doctor’s approval, they’ll find a way to get you that medication.”
8. Ask About Generic and Biosimilar Alternatives
“Switching to generic [medications] can help decrease cost,” says Herring. And that doesn’t mean sacrificing treatment quality, either. “The generic drug companies have to prove to the FDA that they have similar efficacy, safety, and concentration to the brand name in order to get approved.”
So, then, why are generics cheaper? “Unlike the original drug, the generic drug doesn’t have to go through the research stages and pre-clinical trials, so they’re able to produce it at a much lower cost,” explains Herring. So, that savings is passed on to you.
And while some psoriasis medications, like biologics, don’t have generic options, “they have biosimilars, which are more complicated to make than generics, so the cost doesn’t go down as much” explains Herring.
9. Don’t Be Afraid to File an Insurance Appeal
“A big issue is dealing with insurance—whether they’ll cover the more expensive treatments,” says Chang, who says he had to pay out-of-pocket for a phototherapy unit after being denied coverage for it. “It was like a $5,000 unit—which to insurance companies shouldn’t be that much money compared to some of the other things they pay for—but they just refused.”
When that happens, you can file an appeal with your health insurance company. “It can be hard to navigate,” says Chang. “Different states have different laws. It’s all about being persistent and knowing what the rules and the laws are in your state.”
The NPF has a patient navigation center that provides a variety of services, including access to people who can help you navigate the appeals process.
“Don’t give up,” adds Chang. “If the treatment is good, you just have to find a way.”