Does Health Insurance Cover Psoriasis Treatment?

Although each insurance plan is different, medical insurance, including Medicare, normally covers the cost of physician visits to treat psoriasis. Prescription drugs, depending on the details of a particular plan, are covered by most commercial insurance plans.

When a medication is covered, typically the costs of side-effect monitoring for that medication (with blood tests, for example) are covered as well. Other therapies, such as the newer biologics in use, may be covered only after other therapies have failed or if you have psoriatic arthritis as well as psoriasis.

Your employer, insurance company, or physician will have more information about the details of a particular health plan. Some systemic treatments, such as the newer biologic therapies, require preauthorization or prior permission from an insurance company before being used.

Some insurance companies require evidence that other systemic therapies such as cyclosporine or methotrexate are ineffective before giving authorization for treatments. Some plans require a letter of medical necessity from a treating physician. Sample letters to insurance plans can be found at the National Psoriasis Foundation Web site, and many drug manufacturers have specialized groups that help physicians and patients navigate through the approval process (see Appendix for more information).

What is not covered by insurance is the cost of any medicine available over-the-counter at the drugstore.

This includes nonprescription drugs such as Benadryl (diphenhydramine), nonprescription lotions or creams, nonprescription shampoos, and nonprescription medicated creams such as hydrocortisone or Sarna. People with psoriasis may use a significant amount of cream and other skin care products, and the cost of treatment is a common challenge for many psoriasis sufferers.

One of the many challenging aspects of psoriasis is its constant and often high cost of treatment. Research has confirmed that higher out-of-pocket costs add to the suffering of people with psoriasis and other skin diseases.