Health Boards
Tue-18-10-2016, 15:08 PM
Although Rheumatologist can treat osteoarthritis, from my experience it has been better treat through doctor specializing in orthopedics. Osteoarthritis is easy to diagnose with x-ray. Just a suggestion on that.
Sadly there is no clear cut answer to the cost. Sometimes insurance will require you try a medication for a while (like Methotrexate) before you are able to get approved for something else. You may have to fight for this one. If it's not working it will take your doctor getting on board and telling the insurance that the medicine doesn't work for your wife, and if the doctor isn't convinced that she needs to try something else then I'd try another doctor. As you have said, most insurances here will require you to pay 20% which is still quite a bit of money. There are prescription plan supplements but I personally have never checked into those so I'm not much help. I would suggest checking for options with the manufacturer for help but you've already done this so I would check further into that. So first, get insurance approval by getting your doctor or another one to work with you. Second get all the information you can from the manufacturer to see if they can cover your out of pocket expense. Even if it is for only a year at a time then personally I would try it and see how things are in a year. It's possible that you could find help again in a year (as it benefits the drug company so they may extend it) or since we are in an election year who knows how things will be with insurance a year from now (probably not much better, but one can hope!) My understanding is that a lot of the manufacturer's DO offer some help with cost so don't be totally leery of that.... but of course be smart and read all the fine print to make sure you know what they are willing to offer you.
Also a year of relief is just that, a year of relief and it's possible that once clear (not saying Stelara will clear her but you won't know on any of these until they are used) your wife MIGHT be able to maintain her progress on something easier on your finances. There could be other options as well.
Sorry I know that isn't much help but I do know a lot of people in the US are using expensive medicines without paying outrageous amounts so don't think it's impossible
Best of luck!
Sadly there is no clear cut answer to the cost. Sometimes insurance will require you try a medication for a while (like Methotrexate) before you are able to get approved for something else. You may have to fight for this one. If it's not working it will take your doctor getting on board and telling the insurance that the medicine doesn't work for your wife, and if the doctor isn't convinced that she needs to try something else then I'd try another doctor. As you have said, most insurances here will require you to pay 20% which is still quite a bit of money. There are prescription plan supplements but I personally have never checked into those so I'm not much help. I would suggest checking for options with the manufacturer for help but you've already done this so I would check further into that. So first, get insurance approval by getting your doctor or another one to work with you. Second get all the information you can from the manufacturer to see if they can cover your out of pocket expense. Even if it is for only a year at a time then personally I would try it and see how things are in a year. It's possible that you could find help again in a year (as it benefits the drug company so they may extend it) or since we are in an election year who knows how things will be with insurance a year from now (probably not much better, but one can hope!) My understanding is that a lot of the manufacturer's DO offer some help with cost so don't be totally leery of that.... but of course be smart and read all the fine print to make sure you know what they are willing to offer you.
Also a year of relief is just that, a year of relief and it's possible that once clear (not saying Stelara will clear her but you won't know on any of these until they are used) your wife MIGHT be able to maintain her progress on something easier on your finances. There could be other options as well.
Sorry I know that isn't much help but I do know a lot of people in the US are using expensive medicines without paying outrageous amounts so don't think it's impossible
Best of luck!