For most patients with insurance, their health plan often decides which medications they can access and how much those prescriptions cost. But for Medicare patients, that process is managed by regional entities called Medicare administrative contractors.
Training to become a doctor is notoriously grueling. Yet despite the thousands of hours of education, there’s one topic that’s not often taught: how to navigate insurer’s utilization management tactics.
People who have patchy skin discoloration caused by vitiligo often experience social stigma and employment discrimination. The autoimmune disorder is also associated with a five-fold increase in risk for depression. Given these serious harms, why would some state Medicaid programs deny treatment for the condition?
Sometimes patients with skin conditions finally find a medication that works for them – only to be pushed off of it by their health plan. It’s a practice known as “non-medical switching.”
Skin cancer is the most common type of cancer. It strikes one in five Americans and accounts for one-third of all U.S. cancer diagnoses. But, skin cancer is “cancer that patients can see,” and when detected early, it’s highly treatable.
As thermostats turn up, clocks turn back and the calendar turns toward the holidays, ’tis the season for cold, blustery air and dry, flaky skin.
The good news is, November is Healthy Skin Month.
Q: Dear Dr. Derm, eczema problem
While the interconnectedness between eczema – a chronic inflammatory skin disease – and mental health conditions – notably anxiety and depression – is indisputable, it is also manageable.
Eileen Attar’s son Brady lives with epidermolysis bullosa, battling constant sores all over his body. When Eileen’s not caring for Brady and treating his wounds, she’s busy fighting her health insurance company to cover the bandages necessary to keep him alive.
Adam Friedman, MD, discusses recent trends in dermatological care and challenges faced by physicians and patients when trying access prescription medications.
Before the pandemic, I assumed that dermatological care needed to be provided in person. Using telehealth during the COVID-19 pandemic has taught me that is no longer the case.
Everyone, it seemed, was willing to help patients access medication without delay when COVID-19 took hold last year. Some health insurers waived out-of-pocket costs while others suspended prior authorization. One state issued a total ban on step therapy.
The inaugural award recognizes contributions and leadership in patient advocacy
The ever-changing insurance landscape impacts access to eczema care and treatment. We’ll help you sort things out.
Adam Friedman, MD, FAAD, provides insight into how and why insurance companies implement non-medical therapeutic switching and what health care providers can do to mitigate its impact on patient care.
