The RA Money Pit
Have you ever heard this conversation at the water cooler, usually around October or November, when insurance open enrollment is taking place? It goes something like this:
Coworker 1: “I’m trying to decide whether to put any money into the medical flexible spending account, because it’s supposed to be great for your taxes.”
Coworker 2: “Yeah, but the problem with it is that it’s a ‘use it or lose it’ system, so if you don’t use all the funds, you lose the money. That’s why I just skip it.”
Coworker 1: “Maybe I’ll try it out but just go with the minimum deduction each month.”
Me: “Well I always have the maximum amount deducted from my pay, and every year I’ve used it all up by June or July.”
Such is life with rheumatoid arthritis. It seems like I’m in a constant state of sticker shock when it comes to the cost of my medical care. For instance, the full cost of my Orencia injections is over $3,000 a month. Now, thanks to health insurance and a copay assistance program I don’t pay that price, but just let that sink in a minute. That’s over $36,000 a year for a single medication! There are plenty of Americans whose annual salaries are less than that. Therefore, going without health insurance isn’t an option for me, as it would mean going without medication. I have structured my life around maintaining health insurance. Yet in spite of the “great coverage” my job provides, my employee contribution keeps increasing each year, as do my co-pay amounts and deductibles. I always opt for the most expensive plan, as I know that over the year I will recoup the benefits, but it does pack a wallop on my paycheck. And that’s before the medical flexible spending account deduction.
My med-flex account is a bi-weekly reminder of just how much I spend on health care. As I mentioned, I always take the maximum allowance for this benefit. While I appreciate not having to pay taxes on those earnings, it’s frustrating to have those funds deducted from my paychecks long after I’ve already spent them. It’s like a lender than I can’t ever seem to repay. So where does all that med-flex money go? It’s astounding how quickly the copays for doctor’s visits, x-rays, lab work, and prescriptions add up. The out-of-pocket expenses still take my breath away after 15 years on RA meds, and when I look at my insurance statements and see the portions that insurance paid after my bank account-depleting co-pays, I’m simply flummoxed.
Those are just the routine costs, and that doesn’t even take into account the money spent on over-the-counter analgesic pills, ointments, and patches, on splints and braces and ergonomic devices, on the acupuncture, chiropractic, and massage appointments I occasionally treat my aching joints to, or the yoga classes and therapist visits I sometimes attend in an effort to get my RA-exacerbating stress level under control. I haven’t yet had any RA-related surgeries, so I’m fortunate not to add the huge expenses those incur to this list. Yet, many people with rheumatoid arthritis do have to shell out the money for surgeries, physical therapy, and wheelchairs. The figures can become astounding.
Rheumatoid arthritis incurs many figurative costs: costs to my work productivity, costs to my parenting ability, costs to my relationships with friends and loved ones, costs to the quality of my leisure time, and costs to my overall quality of life. When you add the financial costs of RA to all this, this disease feels like a greedy king who will never stop overtaxing his people, no matter how little they may have left to give.
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