Overcoming Barriers to Disease Treatment

Family Features | 1/4/2019, 10:37 a.m.
A diagnosis of a chronic condition such as Crohn’s disease, ulcerative colitis, cancer, or diabetes can bring a swirl of ...

A diagnosis of a chronic condition such as Crohn’s disease, ulcerative colitis, cancer, or diabetes can bring a swirl of thoughts and emotions. There may be relief at finding an explanation for bothersome symptoms, but that relief is often quickly overshadowed by insurance issues, financial concerns, and worry about the future.

If you’ve recently received a chronic diagnosis, take it one step at a time to navigate the road ahead.

Assemble a Team

Working to overcome the hurdles associated with a chronic condition diagnosis can be physically and emotionally draining. In addition to securing a doctor with expertise in treating your condition, you’ll need a support team of family and friends who can serve as a sounding board for your questions and concerns, help with everyday tasks when you’re feeling run down, provide transportation to appointments, and help keep your spirits up.

Understand Your Condition

Arming yourself with information is critical when you receive a life-altering diagnosis. It’s important to understand everything you can about the condition, including known causes, symptoms you may experience, what you can expect as the disease progresses, and more.

If the volume of information is overwhelming, try to consume it a little at a time so you can retain more and give yourself time to process everything you’re learning. As you read, be sure to make notes about things that are confusing or that you might want to discuss with your medical team.

Identify Treatment Options

A big part of your research will likely involve your treatment options. If your doctor has outlined multiple options for treatment, you’ll want to investigate each one thoroughly so you can understand the benefits and risks, as well as deciding which option is the best fit for your particular circumstances. You’ll also want to confirm that your treatment is covered by your health insurance and at what level.

Handle Insurance Issues

Most people assume that if they have health coverage, they can count on at least a portion of the treatments and medications their doctor recommends being covered. In many cases, that’s true, although the exact coverages depend on variables like your plan, deductible, and more.

However, there are also some circumstances in which you may experience a delay before you’re able to follow your doctor’s treatment orders. One example is step therapy – a protocol sometimes used by health insurance companies that requires patients to try and fail on one or more lower cost medications before they will provide coverage for the medication originally prescribed by the patient’s provider.

Step therapy is also known as “fail first” because it requires a patient to fail on an insurer-preferred drug first. For patients with inflammatory bowel diseases (IBD), like Crohn’s disease and ulcerative colitis, this protocol may result in worsened health outcomes. A survey by the Crohn’s & Colitis Foundation found that as many as 40 percent of IBD patients had been subject to step therapy, and 58 percent of those patients were required to fail two or more drugs before being granted access to the drug their doctor originally prescribed.