Severe psoriasis and uncooperative insurers can’t stop Howard Chang

| Howard Chang

(Editor’s note: Howard Chang wrote about his first experience with “Treat to Target” in March 2017. Here he gives us an update on his journey to achieve clearer skin.) 

I usually do not pay much attention to the mail I receive from my health insurance provider. Typically, they send notices or receipts of payment for seeing physicians or special procedures. But one piece of mail felt different than the others. It came overnight with a thick stack of paper inside a large envelope. This was about three weeks after seeing my dermatologist earlier this year.

The letter on top of the stack of papers told the story: My insurance provider denied coverage for a new medication my dermatologist prescribed at that previous clinic visit. The letter went on to explain how I could appeal the denial. When I called the insurance’s customer service line the next day, I found out the dermatology office had already submitted an appeal. 

Two weeks later another parcel arrived overnight – a denial of the appeal. This denial to cover the medication felt final even though it said I could continue appealing. I gave up battling with insurance for my medication that evening.

I did not give up the fight, though, to get the medication. The pharmacy informed me that I could apply for a patient assistance program from the drug manufacturer. I quickly filled out my portion of the forms, included my income statement, and sent it off. A couple more weeks later, I received a call advising me that, finally, the medication was in the mail – almost a month and a half after being prescribed.

Don’t give up!

A theme in my life is don’t give up. I keep this mantra alive not because I am so strong and confident. Rather, I know how weak and easily intimidated I can feel in the face of opposition and roadblocks to accessing care. Psoriasis at times already feels like a heavy weight tied to my leg that I drag around in life. I’m fatigued by the time I need to engage in yet another battle, especially after almost 40 years with severe psoriasis.

It’s important to me, however, to keep trying. If I don’t, then I become defeated and stop truly living. With a church to care for, and a family that depends on me, that’s not a real option. 

I decided during a horrible psoriasis flare about 10 years ago that I needed to advocate for myself even more so than before. I wanted to give up after trying several treatments in succession with little to no positive effect. My dermatologist at the time felt he’d run out of options for me. 

Thankfully, he sent me to a psoriasis treatment clinic at a local university hospital for a consultation. Two options emerged for me that I had not yet tried. I decided on one of those treatments with my dermatologist even though he felt reluctant to prescribe it at first. But after the consultation he decided to move forward with that medication. My psoriasis started clearing within weeks.

I tell this story from time to time partly to remind myself that I haven’t tried every psoriasis treatment and that I’m not out of options. There’s something out there that could alleviate my symptoms. New treatments become available all the time. 

I need to believe and keep that flame of hope alive today more than ever.

Another new beginning

Ironically, I’m probably stopping the medication I fought so hard for earlier this year. After taking it for a few months, my dermatologist and I decided we needed to move on to something else. I don’t like hitting the reset button, but I agree that this one isn’t effective enough for me. Unfortunately, I can’t go back to the drug that worked before, as I need to take a long break to minimize its potential long-term side effects.

At this point it’s easy to think, “Why do I have to go back to the beginning again?” That’s a frustrating and defeating thought. I’d rather see my situation as another new beginning. My dermatologist and I previously discussed an option for my next treatment if this one did not work. Now we’re going through insurance authorization again for this next prescription medication. If they send me a denial letter again I’ll know what to do.

In an exchange with my dermatologist during this challenging time of treatment he wrote, “Let’s keep trying.” With his expertise, my family and friends’ support, and much prayer, I agree. The fight to live a full life with psoriasis continues, and I know I’m not alone. So why not?


Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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