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I have private insurance but my drug is not on their approved list. What steps can I take to get reimbursement?
There are generally three ways in which to get prescription medications in Canada, outside of a hospital. The first is through private insurance, which you may have as a result of your employment or through a private plan that you have purchased. The second is through one of the nineteen public drug plans in this country (one in each of the provinces and territories, and six federal plans), provided that you qualify. And finally you can pay cash, for those who have the means.
Not all private and public drug plans cover all drugs. In the case of private plans, if the medication that you require is not covered, talk to your employer. They may be able willing to work with the insurance company to make the product available to you. Documentation from your physician is important, as it will be necessary to support your request. If your private insurance is not through your place of employment, contact your carrier and find out if there are any mechanisms available whereby you can access an unlisted drug. It’s worth the inquiry.
The drug I have been prescribed is not covered for my condition. What can I do to change this?
The only way to change this is through advocacy, by making your voice heard to those making these decisions.
In the case of the public drug plans, and more particularly the publicly-funded plans in each of the provinces, the first step you can take is to contact your provincial member of parliament (called MP, or MLA depending on where you live). Remember though, you need to qualify for the public plan and the qualifications differ depending upon which province you live in. Secure a meeting and explain to that person that you cannot access a certain medication for your condition. Ask that they work with you to change this by advocating on your behalf to the provincial Ministry of Health. It may take some time and a lot of persistence, but only by standing up and requesting change, can you bring about the change that you need.
I don’t have private insurance. Is there any way I can get my drug costs covered?
If you do not have private insurance through your place of employment and you do not qualify for any of the public drug plans in Canada (and depending on the medications you require), your ability to get your drug costs covered will be limited. You may be able to purchase private health insurance that includes medications, but there is obviously a cost associated with this and not all drugs will be covered. Other than paying cash for the prescriptions you need, other options may include:
- Disease specific organizations (who may be able to identify additional sources of funding)
- Local charities or social service groups (who may be able to identify additional sources of funding)
- Patient Assistance Programs (sometimes available through drug manufacturers)
Discuss these options with your physician and others who you think may be able to help you, and then set about making the necessary contacts to try to get what you need.
How do I start contacting my MP/MPP/MLA to get him/her to help me?
Reaching out to your elected representatives is one of the first and most effective steps that you can take to highlight an issue that you may have with government. Initially, you will need to determine if your issue falls within federal or provincial jurisdiction. In the case of access to publicly-funded medications, for most people they will need to contact their provincial member of parliament. To get started:
- You’ll need to find the contact information for your provincial member. It will be listed in the Blue Pages of your local telephone directory and available on-line through several sources, including your provincial Elections Office (i.e. www.electionsontario.on.ca).
- Provincial members typically have two offices, one at the provincial capital and one in the local riding or district. Telephone the local office and ask for a meeting to discuss your issue.
- If you’d rather not telephone, you can always write to your provincial member at their local office and request a meeting that way. Be sure to include your contact information and a clear summary as to why you need to meet.
- Follow up. After your initial telephone call or letter, keep contacting the provincial member’s local office until you have a meeting date and time secured.
I have just been diagnosed with psoriasis mostly on my hands. I am in my mid-40s, female and want to use skin care products that won't potentially bring on psoriasis on my face or worsen it on my hands. Any suggestions?
The potential for adverse skin reactions to skin care products and/or makeup, is more likely now than ever before because of the new trend geared to Anti-Wrinkle, Anti-Aging, Lifting, and Plumping products. This phenomenon is being fueled by the baby boomers “coming of age”. These new age-defying promoted products are especially sensitive to individuals who are allergy prone and/or have skin sensitivities. I would not recommend using products with any of the above-mentioned product descriptions in the packaging. Also check with your dermatologist that the ingredients listed on the products you do wish to try are okay for you.
The best way to determine whether or not you are going to have a problem or reaction is to do a skin spot test. The inside of your wrist or back of your knee area is a good place to start. If this area doesn’t have a reaction within 24 hours, it is a good sign that you won’t have a sensitive reaction to it.
Is there face makeup that I can use that won't worsen my psoriasis?
The probability of worsening your psoriasis by using face makeup is dependant on your reaction to the ingredients in the products chosen. By choosing products that are allergy and sensitivity tested as well as noncomedogenic, nonacnegenic and perfume free is a good place to start. Check ingredients over with your dermatologist to make sure none of it is on your “to avoid list”.
I have an interview. Is there a way to cover up the psoriasis on my hands?
Make sure that you treat your hands as you would your face by daily and nightly moisturizing habits far in advance before deciding on using a camouflage makeup.
I'd like to wear a strapless dress to a gala event, but I have some red, scaly patches on my shoulders. Is there something I can use to make it less noticeable just for this one night?
Days before the gala event moisturize the area daily and nightly with a very emollient body cream approved by your dermatologist. For the gala event evening, apply a thin layer of a camouflage makeup with a porous dry sponge. If extremely red, apply a “Red Neutralizer” prior to the camouflage makeup. Dust afterward with an oil free setting powder. Dab a dry, clean tissue to pick up excess powder. For touch ups during the evening, carry a touch up kit that you can put together yourself in a small compact that can fit in your evening bag.
I am a female in my early 20’s and embarrassed by the psoriasis on my face. I have psoriasis on my body where I can at least cover it up with clothes but my face? Is there a makeup that can help me cover up the psoriasis on my face?
Yes, you can use a number of foundations and concealers. Depending on the severity of your psoriasis you can either go with a regular fluid foundation or a cake type makeup. The redness can be toned down by using a yellow/green neutralizing color wash makeup then apply a noncomedogenic, nonacnegenic and perfume free foundation and/or concealer.
You can experiment how heavy an application you require by applying a first layer using a porous sponge, then if needed applying another layer. Make sure that the makeup you do choose is recommended for layering.
I’m a man, don't wear makeup but now have some psoriasis patches right around my hairline. Is there a recommendation for cover-up for men?
A lot of psoriasis patients have lesions on or around the scalp line. Try to lessen the patches with a tar, salicylic acid, or zinc shampoo. After treating your scalp with the correct shampoo formulation, use a cover up makeup, applied with a sponge applicator. Finding the exact color is crucial especially for applications around the hairline. Have a reputable makeup artist test the area for the correct color and coverage. Before you buy the concealer, take a look at how the coverage is outside in the daylight hours. You shouldn’t see any lines of demarcation.
Can I use anything to hide psoriasis on my legs?
Yes, I have had clients that were very pleased with the results of using airbrush legs spray. A spray on makeup helps hide redness, varicose veins, scars and other flaws.
Is my psoriasis going to get worse as I get older?
Psoriasis is a chronic disease, and is characterized by remissions and flares and its course is unpredictable.
I have plaque psoriasis on my arms. What¹s the best treatment?
In all areas of medicine, there is no “best treatment”. Many treatment options exist. Your dermatologist based on your previous treatment response and severity of disease will work with you to provide a beneficial treatment plan.
Do all dermatologists specialize in psoriasis?
Dermatologists in Canada complete a 5-year residency program specializing in Hair, Skin and Nails; as such they are experts in skin diseases such as psoriasis. However some dermatologists subspecialize and focus on areas such as surgical dermatology. Some focus more on medical dermatology and psoriasis treatment. Ask your dermatologist.
I understand ultraviolet light therapy is one treatment option. Do most dermatologists have equipment in their offices or are these in separate clinics?
Ultraviolet light therapy can be an excellent option for the treatment of psoriasis. However not all dermatologists have necessary equipment in their office. Some ultraviolet specialized clinics exist and your dermatologist can direct you.
Is it possible my skin will be clear at some point or will there always be some sign of the psoriasis?
Psoriasis is a chronic disease characterized by remissions and exacerbations. Some patients may spontaneously clear, however most require ongoing therapy with topical, ultraviolet light or systemic agents.
I can no longer do my job because I am a painter and the psoriasis is on my knees. I can't kneel any more. What are my options? Can I be fired?
Employers have a duty to accommodate the medical needs of its employees up to the point of undue hardship. In ADGA Group Consultants Inc. v. Lane, an Ontario decision released on August 8, 2008, the Court distinguished between an employer’s procedural duty to accommodate and substantive duty to accommodate. The procedural duty to accommodate requires the employer to obtain all relevant information about the employee’s disability and to seriously consider how the employee’s disability can be accommodated. An employer who does not give any thought as to what steps can be taken to accommodate the employee will have failed to meet their procedural duty to accommodate. The substantive duty to accommodate requires the employer to show that it could not have accommodated the employee’s disability short of undue hardship, meaning without incurring excessive costs or compromising the safety of that employee, other employees or the public.
Your employer should work with you to develop reasonable alternative working arrangements that would be compatible with your inability to kneel which would allow you to continue working. However, the duty to accommodate does not usually require your employer to create a position for you which would not otherwise be needed. If your psoriasis prevents you from being able to perform modified duties or your employer is unable to accommodate you without suffering undue hardship or having to create a new position for you, then your employer would likely be able to terminate your employment and would be obligated to provide notice to you as required by law. If, however, your employer terminates you without attempting to accommodate your medical condition, you should consult with an Employment Law lawyer regarding a potential Human Rights Claim for discrimination on the basis of disability as well as a claim for wrongful dismissal.
Can my employer take action because I have to miss work on a regular basis for my treatments?
If your treatments require you to miss work on a regular basis and your employer is able to handle your absences without undue hardship, the duty to accommodate would likely prohibit your employer from taking punitive action against you and any action taken may be in violation of the Human Rights Code, among other things. The duty to accommodate does not obligate the employer to change an employee’s working conditions in a fundamental way. However, providing it does not result in undue hardship, an employer may be required to implement a variable work schedule with different start times for different days or lighten an employee’s duties or allow that employee to work part time if these steps would allow the employee to continue to work despite their medical condition. You should discuss your medical condition and treatment with your employer and work together to develop reasonable alternative working arrangements that would be compatible with your treatments. Should your employer terminate your employment, you should seek the advice of an Employment Law lawyer with respect to a potential Human Rights Claim for discrimination and a claim for wrongful dismissal.
My medications are really expensive even with private drug insurance. Can I claim any of these medical expenses on my federal tax return?
There are 3 ways to pay for health care expenses.
a. Traditional insurance with monthly premiums. This is paying monthly even if no claims are ever made. There is a good chance you will still have to pay a deductible or co-payment - meaning you are rarely covered 100% for services. In reality you could be paying $1.60 for every $1.00 in health care expenses. If you end up using more coverage than you pay in premiums in a year, your premiums will go up!
b. Paying out of Pocket. We all have the ability to write off a small portion of medical and dental expenses on our personal tax returns but it is very minimal. For example, if you earned $50,000 a year and had $3,000 in medical expenses you would have approximately $255 as an allowable deduction on your personal return.
c. Private Health Services Plans. A Private Health Services Plan allows you to expense your medical and dental costs (for you and your employees) through your company. In 1988 CCRA (Canadian Customs and Revenue Agency) stated that if your medical and dental benefits are administered through a third party arms-length administrator, they can be 100% tax deductible to your company. In addition, these benefits are not a taxable benefit to you or your employees. This means that with a Private Health Services Plan you are able to have a provider administer your benefits plan and you have the maximum tax savings possible.
I have just been diagnosed with psoriasis. Can I still get life insurance?
Generally life insurance contracts are issued standard, that is, the same as someone without psoriasis. For individuals with severe psoriatic arthritis there may be a small to moderate rating depending on the degree of severity. A rating means the premium will be higher.
I already have life insurance so do I have to tell the insurance company I've been diagnosed? Can they take away my coverage?
Any contract issued before the diagnosis of psoriasis (or any other medical condition) is grandfathered. Any new insurance applied for will require disclosure regarding psoriasis or any other medical condition.
How does having psoriasis affect getting disability insurance?
Disability:
Disability Insurance is a more complicated underwriting process than life insurance. Any pre-existing medical condition, such as psoriasis, may be excluded or rated in the contract. The medication used to treat psoriasis can have negative effects on the body. There is potential for disability contracts to be declined due to severe arthritis. Each case will be evaluated on the unique circumstances that apply to the individual.
Critical Illness:
Most cases are issued standard but severe conditions may affect the outcome. Each case will be received and the severe cases of psoriasis could result with exclusions, ratings or a decline.
I have psoriasis and there is a 1 in 4 chance my kids will also get psoriasis. Will they be able to get life insurance coverage?
Children with 1 or both parents suffering from psoriasis should not have a problem getting life insurance. Most cases are issued standard.
How did you get diagnosed?
I was initially diagnosed when I was 18 years old. I broke my leg in a sledding accident and had a cast on my leg for 3 months. This was a stressful event that triggered the initial psoriasis breakout. When the doctor removed my cast my leg was covered in psoriasis and within weeks my entire body was covered. I was sent to the dermatologist and was given creams to try and control the flare up and outbreak. I was absolutely devastated with the appearance of my skin. It was little surprise that I got psoriasis, as it is very strong in my family. My grandfather, mother and brother all had serious psoriasis.
How old were you?
I was 18 years old when I had my initial breakout. I am 32 years old now, so I have this for almost 14 years.
How bad did it get?
The initial breakout covered my entire body. Head to toe, I was covered. It was very difficult to control with a broken leg (see 1st question) as I could not properly take care of the flare up with the cast and there was a significant amount of stress on my body which furthered the severity of the flare up. After my leg healed, I was able to clear up about 50% of the problem, however I would have still been considered a severe psoriasis sufferer. From that point on I struggled with the condition. Sometimes I would go in remission but it was not that significant and didn’t last long.
What is your psoriasis like now?
My psoriasis is now almost non-existent with my current treatment. Different treatments work for different patients. No one is the same or responds the same to the treatments. Keep trying until you find what works for you. I have been symptom free for over 2 years!!!
Did you stop doing anything because of your psoriasis?
My psoriasis was most devastating on my social life and relationships. I stopped playing many sports. I would avoid social activities in the summer because I did not want people to see my skin. I would push away from relationships because I was embarrassed of my skin. It really affected intimacy because I was ashamed of my skin. This was devastating for me, especially during my 20’s. My mood was mostly affected by how my skin was.
What's your advice for someone who has just been diagnosed?
My advice is that there is so much hope!!! Never give up. With the available treatments you can control your psoriasis. I am an example of that. Always take time to treat your skin properly. Make sure you regularly see your dermatologist to discuss your options and treatments. Finally, talk to your friends and family. Make sure you educate them so they will understand and be considerate of your condition.
I have just been diagnosed with psoriasis and I am really angry. I know this is part of my life now but how do I deal with my emotions right now?
Anger is an appropriate reaction to receiving the diagnosis. The idea is to be able to work through the anger as opposed to denying it or avoiding it. That is, let yourself feel the anger and talk to those close to you about your feelings. If you attempt to avoid it or deny it the anger will not go away and you will be experiencing it a lot longer. By allowing yourself to work through it you will probably find that you will begin to feel other emotions as well, such as sadness. Eventually the negative emotions can be integrated into your experience and they will not seem as overwhelming or interfere with your life as much.
I have plaque psoriasis on my arms and I still like to wear short sleeves when it's warm. I feel like people are staring at me and avoid me. How can I manage this rejection?
There are two parts to this answer. The first and most important is, as the saying goes, just do it! The more often you do it the sooner you will get used to it and the less apprehensive you feel about it. Second, you can work on your thoughts about it. Ask yourself:
- Does it really matter what a stranger walking down the street thinks of me?,
- Is the opinion of someone else more important to me than my freedom to choose to wear short-sleeves?
- If I saw someone walking around with a skin condition would I put them down in my mind? What would I think of them?
Questioning yourself like this is called “challenging your thoughts” and can help you to change your perspective on things.
My husband is very supportive and helps apply some my creams to my back. But I feel like it is making me less attractive to him. How do we keep our marriage strong through this?
Your husband’s show of supportiveness is helping to keep your marriage strong. Tell him you appreciate it and why you appreciate it. Discuss with him directly your feelings, both positive and negative. Let him know your concerns, don’t hide them. By having them out in the open you allow him to work with you, you avoid misunderstandings, and it helps you feel closer to each other.
My friends say I should see a therapist or a psychologist to help me deal with my depression. First off, what is the difference and secondly how would I go about finding someone?
The term “therapist”, just like “psychotherapist, counsellor, coach” are generic terms that can create a lot of confusion for people. In most jurisdictions, these terms are not protected by law so that anyone, yes anyone, can claim to be a therapist. If you intend to see someone who only refers to himself or herself as a counsellor or therapist or psychotherapist you will want to spend more care establishing their credentials before consulting them. Terms like “psychologist, social worker, physician, registered nurse” are protected terms under the law and only people meeting certain academic and professional standards can use those terms. It also means that these professionals are members of a profession that has a regulatory body that oversees their work and can handle complaints about their competency. Therefore giving the public some degree of reassurance that these individuals are competent to practice in their respective areas, and recourse if they do not act competently. To find a psychologist you can: ask for a referral from your GP or dermatologist, check with your local state or provincial psychological association for a recommendation, look through the yellow pages for a psychologist that lists “health psychology” as an area of practice or ask someone you know with a chronic health problem for a recommendation.
How do I find a psoriasis support group in my area?
You can check on the web or in the phone book for groups in your area. You can also ask your dermatologist, family doctor, or psychologist. Check with the national psoriasis associations. Also some areas have self−help clearinghouses that maintain a listing of many self−help groups located in a given community. They are a great resource if you have one in your area.
