Virtually all plans that cover treatments have either a stepped approach to covering treatments or a tiered one, or in some cases both. For a stepped approach, what this means is that you need to have tried, without a successful outcome, generally cheaper treatments before they will cover the one or ones on a higher step.
For tiered programs, there are tiers within a given step, based entirely on the cost of each medication to the insurer, and if you try and access a medication on a higher tier without having tried a lower tier one, you will likely be asked for a higher co-pay , or have the coverage denied.
When consulting with your physician for your psoriasis or psoriatic arthritis treatment, it's important for you to be open and honest about your overall physical and mental health. Furthermore, all of your overall medical history needs to be considered. During this process, your physician may discover that a treatment required by your drug plan may not be safe or appropriate for you given past experience or other health issues you may have. In such cases, you may be able to 'skip' a step or two and move forward with the medication on a higher step. Also, in some cases for those psoriasis patients with sore or inflamed joints, a prescription written by a rheumatologist may be covered when the same prescription may be denied if prescribed by a dermatologist.
Next step: please see the chart of contraindications.
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