A recent National Rosacea Society survey found that prescription rosacea medication continues to be a covered expense for most patients, but there’s little appetite from insurance companies to cover laser treatments.
In the survey of 560 rosacea patients, 97% of respondents reported that they have some type of health insurance, including private insurance and Medicare/Medicaid. Of those insured, more than 71% said their insurance covers some or all of their prescribed 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 3% of the respondents said they had coverage for such procedures.
Many patients reported frustration with their health insurance’s lack of laser treatment coverage. One respondent commented, “Four dermatologists have told me the most effective treatment is laser therapy. This country has to do better to push insurance companies to cover laser treatment.” Another said, “I have used IPL for both facial and ocular rosacea. Though very expensive, the treatments have been effective enough to continue paying out of pocket. However, being on a fixed income at age 70, some help from insurance would be appreciated.”
Out-of-pocket expenses or delaying treatment seem to be common occurrences for rosacea sufferers. The lack of health insurance or the high cost of the required copay kept 52% of survey respondents from obtaining medical care for their rosacea at some point, and 66% reported they had paid out of pocket for a rosacea-related medication or procedure. The amount paid out of pocket was less than $100 for 28% of respondents, between $100 and $500 for 36%, between $500 and $1,000 for 12%, and greater than $1,000 for 13%.
“While many front-line treatments for rosacea are covered, it often varies widely from plan to plan. We always encourage our patients to check their insurance plan to understand what is and isn’t covered,” said Dr. John Wolf, professor and emeritus chair of dermatology at the Baylor College of Medicine. “Using medications consistently in combination with avoiding triggers helps patients manage their rosacea, and we want to work with our patients to put together a treatment plan they can successfully implement with their existing coverage.”
The good news is there is a significantly broader range of prescription therapies available to treat the signs and symptoms of rosacea compared with a decade ago, and several are available as generics. As a result, rosacea patients now have other options to try if the front-line treatment turns out not to be effective in their case.