Psoriasis is an autoimmune disorder that causes itchy, inflamed lesions on the skin. Most people who have psoriasis need to see healthcare providers on a regular basis. Ideally, they see providers who specialize in treating skin conditions. Unfortunately, access to care can be challenging for some people with psoriasis.
This article discusses barriers to treatment for people with psoriasis and how to overcome them.
Access to Care and Psoriasis
Access to care means having the ability to see the kind of provider you need, when you need to see them. It also means getting effective, affordable treatment for your health condition.
According to the US Department of Health and Human Services’ Agency for Research Health and Quality, factors affecting access to care include:
- Insurance coverage
- Access to a healthcare facility
- Ability to get a timely appointment
- Treatment by qualified healthcare providers
People with psoriasis usually need regular health care to address their symptoms, keep the condition from worsening, or prevent it from affecting the joints. Although it can be mild, psoriasis can also be severe and is sometimes a complicated disease to treat, so the ability to access care is vital.
- Thickened, raised rashes
- Scaly, itchy skin
- Joint inflammation
People with severe psoriasis are also at a higher risk of developing heart disease or other serious health conditions, so they need to be monitored for co-occurring conditions as well.
Access to Psoriasis Specialists
One study of psoriasis patients showed that more than 90% had seen a provider in the prior two years, but only about 78% of those patients saw a provider who had specialist-level training.
Access to Care Issues for Psoriasis Patients
Some people with psoriasis come across barriers to access to the kind of specialized care they need. There are several reasons why it may be difficult, including:
- Insurance: If you are uninsured or have limited coverage, your insurance provider may deny or not cover some effective but expensive treatments like biologicals.
- Out-of-pocket costs: Charges paid directly by psoriasis patients account for about 55% of the total cost of treatment.
- Dermatologist shortage: Many people in the US live in areas where there are not enough dermatologists. That can translate into long wait times to see a provider.
- Rheumatologist shortage: There is a similar shortage of rheumatologists in the US
According to research among people who did not see a provider for their psoriasis for more than two years, the main reasons they cited were abandoning treatment altogether and high costs.
Does Insurance Cover Psoriasis Treatment?
Individual health insurance policies vary, but insurance coverage for biologicals, one of the most effective treatments for moderate to severe psoriasis, can be difficult to obtain. You may need to get a prior authorization through your provider or show that you have tried other treatments. There may be financial assistance available if your insurance does not cover the treatment your provider recommends.
Improving Access to Care
Changes in healthcare delivery have made access to a provider and financial aid easier for some patients. Some of these improvements include:
- Free or low-cost dermatology clinics for Medicaid participants or people without insurance
- Telehealth and teledermatology for those on Medicaid, or for people living in areas where there are not enough dermatologists
- More primary care providers receiving additional training in dermatology
- Help to cover costs, including co-pay cards, patient assistance programs, free health centers, and nonprofits
- Pharmacy cards that can help you find the lowest prices for prescription medication
Some longer-term solutions that are being examined to improve access to care include:
- Direct access to specialists, so that you don’t have to have a referral to see a dermatologist
- Increasing the number of practicing dermatologists and rheumatologists
Ask your healthcare provider or visit the official federal website, USA.govfor more information on paying for medical care.
People with psoriasis can experience challenges with access to care. This can include the inability to see a qualified provider in a timely manner, and getting appropriate, affordable treatment. Lack of insurance or inadequate coverage, high costs, and a shortage in the number of specialists contribute to the problem.
Telehealth visits, free or low-cost dermatology clinics, financial aid, and healthcare providers who have received additional training in treating psoriasis can help address these access to care issues so people with psoriasis can get the help they need.
A Word From Verywell
Psoriasis symptoms and pain can be difficult to live with, but fortunately, there have been big strides in treatment in recent years. Many people with psoriasis respond to these new medications or even achieve remission. If you are having trouble finding treatment or affording the cost, look into the resources covered in this article to help you manage your psoriasis.
Frequently Asked Questions
How does psoriasis impact quality of life?
Mild psoriasis does not generally affect quality of life in an overwhelming way. But if your psoriasis is severe, or if you have psoriatic arthritis, which can cause disabling joint pain, it can make it harder to go about your daily activities comfortably. Newer treatments like biologicals can be very effective in treating psoriasis symptoms.
What happens if psoriasis is left untreated?
Psoriasis is more likely to develop into psoriatic arthritis, a painful condition that can damage the joints, if it’s left untreated. Psoriasis can also be linked to other health conditions including heart disease, so treatment to manage psoriasis is important.
Does insurance cover psoriasis treatment?
Health insurance policies vary, but insurance companies may decline to cover certain psoriasis treatments that can be expensive but very effective for moderate to severe psoriasis. If your treatment is denied, you can appeal the decision, ask your provider to request prior authorization, or apply for financial assistance from foundations, the federal government, or pharmaceutical companies.