Despite the growth of managed care and pending changes in health insurance as a result of the U.S. Affordable Care Act, a new survey found that prescription medication is currently a covered expense for most rosacea patients.
In the survey of 1,259 rosacea patients conducted by the National Rosacea Society, 90 percent of the respondents reported that they have some type of health insurance, and of those, more than 72 percent said their insurance covers oral and topical rosacea therapy. On the other hand, the survey found that medical procedures, such as laser or other light-based therapy to remove visible blood vessels, are often considered cosmetic and rarely covered by insurance companies. Only 5 percent of the respondents said they had such coverage, 35 percent said they did not and 60 percent said they didn’t know.
“Studies have shown rosacea can usually be well managed through a combination of medical therapy and trigger avoidance, so a lack of health insurance coverage could lead to more frequent flare-ups if a patient only avoids his or her individual triggers,” said Dr. Julie Harper, clinical associate professor of dermatology at the University of Alabama-Birmingham. “In addition, because of the physical and emotional pain of rosacea, a strong case might be made that surgical procedures for this disorder are more than cosmetic.”
The lack of health insurance or the amount of the required co-pay kept 47 percent of the survey respondents from obtaining medical care for their rosacea at some point. And 56 percent reported they had paid out-of-pocket for a rosacea-related medication or procedure not covered by their insurance policy. Of those answering the survey, the amount paid out of pocket was less than $100 for 33 percent, between $100 and $500 for 35 percent, between $500 and $1,000 for 12 percent and greater than $1,000 for 11 percent.
Those who reported spending at least $1,000 out-of-pocket were more likely to have more severe cases of rosacea. Twenty-three percent of those spending the most money said they had the skin thickening and enlargement of subtype 3 (phymatous) rosacea, compared to only 18 percent of the total sample, and 46 percent noted that they had the eye irritation of subtype 4 (ocular) rosacea.
Just having adequate health insurance does not necessarily mean smooth sailing for every rosacea patient, however. Eleven percent of those taking the survey reported that they have had to dispute charges relating to rosacea treatment with the insurance company. Twenty-one percent said they are required to obtain a referral from their primary physician in order to see a specialist such as a dermatologist or eye doctor.
Many patients reported frustration with their health insurance coverage as it related to their rosacea, especially when it refused to adequately pay for therapy that had been effective for them.