Navigating Insurance Nightmares

 

For release 6/18/24

 

PODCAST OPEN:           

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MUSIC BRIDGE

 

Sarah Cloud:

Hi. Welcome to the Live Yes! With Arthritis podcast. I'm Sarah Cloud, your host for this episode. I was diagnosed with osteoarthritis at 19 and then with rheumatoid arthritis and EDS [Ehlers-Danlos syndrome] in 2019. I am mom to Chris, who was diagnosed with juvenile arthritis when he was 12 years old. And my husband has ankylosing spondylitis, who was diagnosed more than 10 years ago.

 

Navigating health insurance can often feel like walking through the minefield. Surprise billing, step therapy, out-of-network providers and claim denials are just a few of the landmines us patients living with arthritis often must traverse to get to the necessary access to treatments. In this episode of the Live Yes! With Arthritis podcast, we will hear real stories of two people living with arthritis and how they are overcoming their own hurdles to health insurance to gain access to the care they need.

 

Today, I'm joined by Penny Greenblatt and Jed Findley, both of whom are no strangers to navigating the hurdles of health insurance. Penny and Jed, welcome to the podcast.

 

Jed Findley:

Thanks for having us today.

 

Penny Greenblatt:

Hi. Thanks for having us.

 

Sarah Cloud:

Penny, tell us a little bit about you and your arthritis.

 

Penny Greenblatt:

I'd been diagnosed with psoriasis when I was 28. At 32, I started to develop some odd symptoms, as eye inflammation that didn't go away, tendon pain, joint pain. Kept going for about seven years until my entire body was hurting. And then I was diagnosed finally with psoriatic arthritis. That was over 40 years ago. I'm a long hauler in this.

 

I went through many different types of medication, or at least tried different medications, but there was not a whole lot that existed back then. And then finally, the biologics came along that were a game changer. Now I'm on Medicare, which is what I'll be talking about, my experience.

 

Sarah Cloud:

Well, thank you, Penny. Jed, can you tell us a little bit about yourself?

 

Jed Findley:

Yeah, I was diagnosed with ankylosing spondylitis back in 1994 at the ripe old age of 12. Much like Penny, there was not a lot of treatment to be had at the time, at least not for someone as young as I was. So, I was told to just kind of get through it, live the best I can and try to stay active. Since then, I've started receiving health care and insurance through my employer. And I have finally been able to get the treatments that I so needed but didn't actually fully understand at the time how desperately I needed it.

 

When I'm not going to doctor's appointments and getting treatments, I'm a chronic illness advocate and a patient leader for ankylosing spondylitis and all the other fun chronic illnesses there are in the world. So, it's really great to be here today talking about this super important subject.

 

Sarah Cloud:

Thank you, Jed. I have to say that between the three of us, I think we cover just about all the groups. (laughter)

 

Penny Greenblatt:

Sadly, yes.

 

Sarah Cloud:

Earlier, I mentioned a few of the common challenges with health insurance, including, but not limited to, things as simple as not understanding what type of plan or coverage you have — employee, government, marketplace. Not keeping accurate notes for what you need, who you talk to, what was the outcome; and not understanding or knowing how to navigate the system of networks: approvals, co-insurance, pharmacy benefit managers. Penny, can you tell us a little bit about the type of insurance you have and the greatest challenges you've had with it and how you overcame them?

 

Penny Greenblatt:

I went on Medicare about eight years ago. Prior to that, I had started Enbrel, which is one of the biologics, and it was a game changer. I jumped through all the hoops through my insurance company, through my employer, to get everything approved so that I was on Enbrel. Everything was great. Thanks to a copay assistance program that the pharmaceutical company has, I was paying $10 a month out of pocket, that was it. Otherwise, it would've cost me about $400 a month out of pocket.

 

And then I went on Medicare. And I had heard that you could not get copay assistance, so I called the pharmaceutical company who handled the plan, the copay assistance plan. And unfortunately, there's a very archaic statute that prohibits anybody on Medicare from getting copay assistance. Makes no sense whatsoever, because when you're on Medicare, you tend to be on a fixed income and don't have lots of money to throw around. And you can't get this copay assistance.

 

So, at the time, it would've cost me about $12,000 a year for my Enbrel instead of the $120 I was paying when I was working. They said, "Well, they do have some sort of a foundation that can provide subsidies if your income is low enough." Unfortunately, my income is not that low, so I qualified for nothing. I had heard that if you go on to an infusion medication — there are several of the biologics that are in infusion form — if you do that, it's billed through your Medicare Part B, and you don't have to pay anything. I had to start going to an infusion center every eight weeks to sit for four hours getting an infusion, instead of a very simple self-injected Enbrel injection each week.

 

Medicare is great insurance, other than some small copays with the prescription plan. But when there's something like a very expensive drug, like the biologic, forget it. There's really not much you can do. So, I was doing the infusions. Then after a couple of years, it stopped working altogether. Fortunately, there was one other infusion available, another biologic. We switched to that. So far, it's working. If it stops working like the other one did, I'm kind of out of luck.

 

Sarah Cloud:

Well, I'm hopeful it does keep working. My husband has Medicare and so does my son. But I have employer coverage, so mine's primary. I haven't had to navigate the Medicare and biologics just yet. I've had to navigate for the rest of their services.

 

Penny Greenblatt:

Which is never easy.

 

Sarah Cloud:

I do this for a living, and it's never easy. Jed, tell us your story with insurance, what type of insurance you have and the greatest challenges and how you've overcome them.

 

Jed Findley:

I just wanted to comment on one thing Penny said about how they did not want to cover at-home injections, but they were perfectly OK covering infusions. It's the same type of medication. “We'll cover this, but we're not going to cover this.” And you just have to scratch your head and say, “Why?”

 

Penny Greenblatt:

It's costing Medicare more money for my infusions than if I was getting the copay assistance through the pharmaceutical company.

 

Jed Findley:

Exactly, yeah.

 

Sarah Cloud:

So, once a medication is taken at home, it's no longer covered under Part B insurance.

 

Penny Greenblatt:

Right.

 

Jed Findley:

My story when it came to insurance was: I was working part-time as an after-school tutor, and I was working at a radio station that did not provide any benefits whatsoever. I started reaching out to all the companies, saying, "Hey, here's the plan that I can afford. I'd like to have this one."

 

They didn't even know what ankylosing spondylitis was; it was just on a list. I would imagine it has to do with the cost of biologics, and that's what they were trying to avoid. And therefore, I couldn't get insurance. It wasn't until I received full-time employment that I finally got employer-provided insurance. And suddenly, I was able to get coverage.

 

My employer pays the first thousand dollars of my deductible. Most years, I go without paying pretty much anything except for copays and whatever the pharmaceutical company wants to pay after the copay assistance. For the most part, it's been great. I've had good coverage when it came to biologics. A lot of times, I haven't paid anything after the copay assistance.

 

The one place where I kind of ran into it was when insurance decided they didn't like how often I was taking my biologic, and they wanted me to cut back on it, because they really felt like I was taking it weekly because I wasn't getting as much benefit out of it as I feel I should've been. So, my rheumatologist said, "All right, we'll, we'll set you up for weekly."

 

And then insurance said, "Oh no, every other week should be fine for you." Well, it wasn't fine for me. I'm trying to live a functional life. Everyone deserves to live at least a functional life. That was about the one time I really ran into it when it came to my totally awesome employer-provided insurance plan.

 

Sarah Cloud:

They seem to think that we're just injecting ourselves for the fun of it. Well, I can think of much better Sunday afternoon activities myself.

 

Jed Findley:

As can I. (laughter)

 

PROMO:

Your voice matters. You have the power to make arthritis a higher priority in American health care. Influence state and federal policies, health care laws and research funding … and bring arthritis out of the shadows. Go to arthritis.org/advocate and sign up.

 

Sarah Cloud:

When I swapped careers, I had stayed in my last profession until my body broke down. I just couldn't do it any longer. I had to leave. And I think sometimes our insurance being attached to our professions can be a double-edged sword. Because once you leave, what am I going to do with health insurance? And when I was looking for my new career and to jump into the medical field, that was the first thing. My question was: What is their benefit package? That heavily factored in because I'm the main insurance carrier for the whole family.

 

Penny Greenblatt:

The job I retired from: I basically was working for my health insurance. I really wanted to stop working earlier because, physically, it was just really stressful on my body. I had a very stressful position and was having orthopedic surgeries left and right. I just was ready to retire and relax a little bit; and I couldn't. I had to work. I was paying my insurer. I was basically working for my insurance at that point. And the minute, the instant, Medicare kicked in, that was it. Retirement party, I'm out of here.

 

Sarah Cloud:

We'll find a lot of people are in that same situation.

 

Jed Findley:

Yeah.

 

Sarah Cloud:

Before each episode, we post a question on social media. And for this episode we asked, “What has been your greatest challenge with health insurance and how did you overcome it?” And we got some really great responses. Disabled Gardener has said, “The biggest challenge I have is getting a referral to a rheumatologist. My insurance wants to send me to a doctor for each joint I’m having issues with, and I feel like there needs to be one who oversees it all. But they won’t approve me for rheumatology because I don’t have RA. With OA all in my joints, I think one doctor should manage it.”

I have a rheumatologist for OA. (laughs)

 

Penny Greenblatt:

That's right. That's what they do.

 

Jed Findley:

Right. (laughs) That's amazing. I live in the St. Louis, Missouri area, and when I first started looking for a rheumatologist, here was 13 choices. And I was quote, unquote, "rejected" by all 13 of them because they were full up. They didn't have time for me until number 13 called me back and said, "You know, the doctor finds you interesting, and she'd like to treat you." (laughter)

 

There was so many hoops I had to jump through just to get treatment at first. I had to do physical therapy, and I had to try more holistic… They were even OK with chiropractic before they would start allowing this rheumatologist to treat me. We're talking about hoops you have to jump through for absolutely no reason whatsoever.

 

Penny Greenblatt:

Because it's cheaper.

 

Jed Findley:

Yeah.

 

Sarah Cloud:

I don't think it's cheaper after they send you to nine specialists. (laughter)

 

Jed Findley:

They don't think about that, do they?

 

Sarah Cloud:

My question for them would be: Who's refusing to give the referral? Either the primary? Or is insurance stating you can't see rheumatology without the referral? And can you self-refer? Because I know with my insurance, I can self-refer to rheumatology. I don't actually need a referral from the primary care. However, our rheumatology will not take you without a referral from your primary care.

 

Jed Findley:

Oh, that's interesting.

 

Sarah Cloud:

We've had a few on the southern half of Missouri who have retired or moved. So, there's been some bouncing of patients.

 

Jed Findley:

I also can self-referral. I do not need that letter of recommendation to go to a rheumatologist. In the St. Louis area, we have two big hospitals, great rheumatology departments, but they are so full up on people. I think it's like a three-year waiting list on both of them that you actually do need… It's not so much a referral but a recommendation…

 

Sarah Cloud:

Yes.

 

Jed Findley:

…from another doctor saying, "You know what, I've worked with them. They're a good patient, and I think you should give them a chance." Or however that conversation goes. I've had a few doctors who knew who I was, so they were excited to treat me, which I know was not a case for 99% of the population. So, my advice if you want good treatment is go online. You do a couple of talks, you know. Lead a couple of support groups. Really get your name out there. And then you can finally start getting treatment.

 

Penny Greenblatt:

That's really sad. I mean, you should just be able to pick up the phone and schedule an appointment. I'm in the Los Angeles area and there are a lot of rheumatologists out here. And I've also always been at a PPO for that reason, so I wouldn't have to get the referral. And for Medicare, I'm on straight Medicare, and I could save a lot of money being in an Advantage plan, but I'd have to deal with referrals and the possibility that they would deny me seeing a rheumatologist. So, I pay for straight Medicare, which is quite expensive overall. It's a pretty sizeable premium. But it's worth it.

 

Sarah Cloud:

We’ve relocated here back to Missouri. I grew up in the Midwest. And I lived in Utah for 20-plus years and worked with the Foundation and with our JA families for Utah, Idaho and Montana. For the most part, our kids with JA, if you live in Idaho, Montana or rural parts of Utah, you are going to Salt Lake. Many of our Idaho families go to Spokane. If you live in Alaska, generally, you have to fly to Seattle. And so, for the pediatric world, we're used to that. We are finding that getting into rheumatology is becoming difficult because everybody is retiring.

 

Penny Greenblatt:

And I guess the takeaway from all this is: If you're going to get some sort of rheumatological condition, live in a big city.

 

Jed Findley:

It's not just what insurance you have, but where do you live? You shouldn't have to go to a different state for something as common as rheumatology. You know?

 

Sarah Cloud:

When we lived in Southern Utah, we could not go to Las Vegas, which was two hours from us, because their rheumatology, there were 16 of them, were not in our insurance network. So, we drove to Salt Lake, which was 300 miles and a five-hour drive, because they were in our network. And according to the insurance company, it was a super specialty and did not apply to out-of-network rates. So, my advice to everybody is know your plan, know your network. Know it before you sign up for that coverage if you're buying it through something other than work, or if you have work options as to a PPO and an HMO, because you could have rheumatology near you and still not have access to it.

 

Jed Findley:

Wow. Just wow.

 

Penny Greenblatt:

Yeah.

 

Jed Findley:

I mean that, ugh. It's not OK.

 

Penny Greenblatt:

What happens if you've got great coverage, but then you develop a rheumatological condition that doesn't happen to be part of what they see as necessary or is out-of-pocket network or whatever could possibly happen after you've already gotten into this great plan. You're kind of stuck.

 

Sarah Cloud:

Appeal.

 

Penny Greenblatt:

Yeah.

 

Sarah Cloud:

Appeal.

 

Jed Findley:

Yes.

 

Sarah Cloud:

And then we appealed even higher to the employer who paid for the plan, and they ended up being able to help get us a 90-day coverage. And then after that year was over, they actually swapped insurance plans because we did the cost breakdown, and it was costing my employer more than it was saving the insurance.

 

Jed Findley:

That’s the thing, it’s appealing. What I do when I talk to groups of patients is encourage them to be advocates for themselves. But, what does your average patient know about the inner workings of insurance or how to appeal? Or even just have the time and the energy to go ahead and do that?

 

Sarah Cloud:

I work in health care finance. Nothing makes sense.

 

Jed Findley:

No.

 

Penny Greenblatt:

No, nothing.

 

Jed Findley:

I wrote an article a number of years ago that was called “This Is Not My Job.” And it was just a list of all of the things that patients are expected to do where that's not our job. We shouldn't have to be appealing. We should not have to know exactly how the plan works and what hoops you need to jump through to get to that point.

 

Penny Greenblatt:

We shouldn't have to be doing this much fighting either. It just takes way too much energy. You need to save your energy for your healing. You shouldn't have to be fighting constantly every step of the way. And you shouldn't have to be dealing with insurance companies who are making decisions that they don't know what they're talking about. It's not up to them to be telling you who you should see and who you should not see. Or what medication you should take because it's cheaper. It's not an insurance company decision, it's up to a doctor.

 

Jed Findley:

Right. It should be the doctor and the patient, and not the guy in the office who has a list of what conditions you're allowed to have and which treatments you're allowed to take because of that.

 

Sarah Cloud:

Well, I changed careers. I drove a school bus for 22 years. Into health care management with the knowledge of 10 years of fighting insurance for my child's care and getting his care and how to navigate the system. I decided to go to college for a degree in health care management and ended up pulling straight As. Apparently, I already understood how the system works. So, you can get a full-time job in this that actually pays more than just managing your own health insurance.

 

Jed Findley:

Yeah.

 

Sarah Cloud:

One of the other questions somebody sent in, I'm not sure if there are answers for. It says, “TMJ due to arthritis that affected the jaw joint is excluded, but arthritis in other joints is no problem. Certain states mandate that they must treat arthritis in the jaw like any other joint, but New York does not. No treatment, therapy, medications or surgery for the most severe cases, nothing." And the reason this stands out to me is I am in the process of seeing a TMJ specialist. My dental insurance does not cover it, and my health insurance may not cover it. So, I'm in the balance of: Do we treat it? Is it caused by arthritis? Is this something else? But I'm also losing my hearing because of it.”

 

Jed Findley:

Wow.

 

Sarah Cloud:

That one intrigues me because I'm in the same boat.

 

Jed Findley:

I grew up in the New York area, and it's probably because New Yorkers talk so much that they've been wearing out their jaws.

 

Penny Greenblatt:

(laughs) So, everyone there has it.

 

Jed Findley:

Everyone’s got it, yeah. Eventually, they’re all going to develop it. So, they don't want to cover it. I mean, does that seem farfetched, though? I mean, obviously I'm joking, but I mean, the jaw cannot be insured. Everything else is fine, but not the jaw. No, sorry.

 

Penny Greenblatt:

Well, again, it comes down to pick where you're going to live. If you're going to have a problem with your jaw, live in another state, that's all. Very simple. Just don't live in New York.

 

Sarah Cloud:

Don't you love how that has been the response to some of our patients is: "Just move."

 

Jed Findley:

Just move. Try again.

 

Penny Greenblatt:

Move.

 

PROMO:

Whenever you need help, the Arthritis Foundation’s Helpline is here for you. Whether it’s about insurance coverage, a provider you need help from or something else, get in touch with us by phone, toll-free, at 800-283-7800. Or send us a message at arthritis.org/helpline.

 

Penny Greenblatt:

I think it's just a matter of advocating like crazy, advocating for yourself. Takes a lot of time and energy, but it's about the only way to do it.

 

Sarah Cloud:

It's a good thing that we bring it up because some of our listeners may have dealt with this. They may have tips and tricks. And how did you do it? And where do we start on this? Are you appealing to dental? Are we appealing to medical? What should our patients do when it comes down to the TMJ, because that's that one area that nobody seems to want to claim on either policy.

 

Jed Findley:

But why?

 

Sarah Cloud:

Probably because it costs too much.

 

Jed Findley:

Possibly, yeah.

 

Penny Greenblatt:

And if they could avoid paying for it, they'll do anything they can to avoid paying for it. Sad but true.

 

Jed Findley:

Everything comes down to money and how much money it's going to cost you.

 

Penny Greenblatt:

The really sad thing is that when they don't pay for it, and then the condition gets worse and worse and worse, eventually you need some sort of expensive surgery to correct all of the damage. And it ends up costing them more in the long run than if they'd just taken care of it in the very beginning.

 

Sarah Cloud:

Oh, and how true is that. And that actually leads us into another response for social media who said, "My knee replacement has been denied after the fact. I am only just learning about it. My husband's hip replacement by the same surgeon and the same insurance plan was approved only last August. I haven't followed up on this yet, and I'm really hoping it's some kind of oversight." I love when they deny it after the fact.

 

Penny Greenblatt:

If that's the case, then the surgeon's office should be the one fighting it if they'd already had the authorization.

 

Sarah Cloud:

I would be calling the surgeon's office. And I would be also calling the insurance company. And I would ask how that was billed, all the way down to the CPT codes as to what was billed and what the response was.

 

Penny Greenblatt:

There's also this: the state insurance commissioner. Go to the state insurance commission.

 

Jed Findley:

Write that down, everyone.

 

Sarah Cloud:

I'm going to recommend to everybody that A) If you have employer-sponsored health coverage like myself, your state insurance commissioner generally does not handle ERISA plans. Those are handled through the Department of Labor. But if you have a state-funded plan, file a complaint with your state insurance commissioner if you're having issues, if you're having problems with your insurance not billing correctly. Or your coverage is having issues, you're having a problem with a prior authorization, whatever it is. When you talk to your insurance company, get the name of the person you spoke with and a reference number for the call. And write down what you talked about, their name, their reference number and the time of the call.

 

Jed Findley:

Unfortunately, I have found just in the past two years alone, things aren't working out quite the same as they used to. And you know, maybe it's staffing issues. Maybe the doctors, insurance, are actually expecting the patients to do more. I don't know.

 

Sarah Cloud:

Advocating for yourself, but also understanding what's in your plan, what is your network. So many people I ask, and they do not know, if they have an HMO or a PPO or an EPO. And that makes a difference. But if you don't know who your network is, you could get some surprise bills because it's out-of-network.

 

I have one more question. Let's see. “Having medication that has worked for you in the past denied because you need to fail first with a recommended medication.” Oh, we love those.

 

Penny Greenblatt:

Oh, step therapy.

 

Sarah Cloud:

“After failing at that recommended medication, they no longer cover the original one you needed to begin with.”

 

Jed Findley:

Oh, twist. That's a twist in the storyline right there. Oh, wow. It's not OK.

 

Sarah Cloud:

Ouch.

 

Jed Findley: Obviously, one big thing that people in the rheumatological world are dealing with now are biosimilars. They were more willing to let me try straight-up chemotherapy than they were letting me just try a simple biologic. So, I'm really glad that I didn't have to do that step therapy.

 

Sarah Cloud:

Well, I think it depends also what state you live in. Because I know there are many of our states that have guardrails on that now, although I don't think we have that as of yet on the federal side. So, it really depends.

 

Penny Greenblatt:

Yeah, it sounds like this particular person who wrote in, even if they had approved it initially, then they stopped covering it anyway. So, I think they would've been stuck, no matter which way they had gone. Whatever had happened, they would've not been covered.

 

Sarah Cloud:

It sounds like a formulary issue. And it makes you wonder if they took the brand name off the formulary. A lot of insurers in the last year are taking certain brand name biologics off the formularies and putting the biosimilars in their place. And that sounds like that could be part of their issue.

 

Jed Findley:

People are asking, "Well, what's the best biologic to take?" And there is no answer for that. It just depends on who you are. And maybe these biosimilars will be great for someone. I would love to think that they'd be great for me because I don't want to spend money for a brand name if I don't have to. I get it.

 

Maybe you don't have to get to that point where you spend money on the people when it don't work in the future, you know? Right now in this conversation, we have three people who are experienced and educated. And we know what we're talking about. We've been around the world a few times in the medical field. But I think, you know, most people listening probably don't have as much experience.

 

Penny Greenblatt:

Exactly.

 

Jed Findley:

I thoroughly believe that if the doctors or insurance is not providing some kind of, “Hey, welcome to your condition. Here's some things you need to know.” Different nonprofits like the Arthritis Foundation, it's important to get involved with the organizations and get to know people who have experience so that you can fully understand everything that's involved before you get too deep into it. I'd say my online support group, which has, I don't know, what are we up to like 40,000 people or something like that.

 

Penny Greenblatt:

I think people don't know what they need to know.

 

Jed Findley:

That, too. Exactly.

 

Penny Greenblatt:

Yeah. They don't even know which questions to ask. The Connect Groups are great for that.

 

Jed Findley:

They sure are.

 

Penny Greenblatt:

I wish I'd known about the Arthritis Foundation and the Connect Groups… Well, I don’t think the Connect Groups were even anywhere nearly developed at that point. But the Psoriatic Arthritis Connect Group that I co-facilitate is just a great resource. I wish I had had that. Going to the Arthritis Foundation website, I think, will get a lot of questions answered. If they find the Arthritis Foundation, they can get a lot of the questions answered and find out what questions to ask.

 

Jed Findley:

The best part about it, the Connect Groups, is that we have the time. We're not complete experts, but we do have the knowledge. And if we don't have the answer to a question, we can hopefully connect you with someone who may have that.

 

Sarah Cloud:

If it was not for those JA moms who, across the internet and phones and emails and conferences — I guess now we call it JA Family Summit — without them, I don’t think I would’ve survived. Because that’s who taught me how to appeal. That’s who taught me that the first question is, “Have you talked to the Arthritis Foundation?”

 

Jed Findley:

I honestly believe they’re doing their best. You know, when you have a six-month waiting period, which means you have that many patients. However many appointments you have a day. They don’t have time to meet with every single person.

 

PROMO:

The Arthritis Foundation is always looking for new ways to inform you about the things you want to know more about. Check out our webinars — in real time or on demand. Visit arthritis.org/webinars to learn more.

 

Sarah Cloud:

Well, to close out each episode, we typically share our top three takeaways from this episode. So, Penny and Jed, what are your top three takeaways from today’s episode?

 

Penny Greenblatt:

Well, one of mine is that people have to learn to advocate for themselves. Number one: Advocate, advocate, advocate. And don’t take “no” for an answer.

 

Jed Findley:

Agreed. People need to get better educated on the process of health insurance and going to the doctors and pharmaceutical companies and everyone else who's involved. Because in the world we're living in right now, patients need to be a lot more active in their own treatments. They need to be professional patients. And be willing to know where to go when you need answers.

 

Sarah Cloud:

I agree. I think as a patient, you are your own first advocate. And as a parent of a JA patient, I am my child's first advocate, although now that he's an adult, I do make him do it himself. But I think it's very important that patients know their insurance. What plans do you have? What coverages do you have? You have to know what you have to begin with. And we have to advocate. And we have to learn. And as you said, Jed, we have to be professional patients.

 

Jed Findley:

You need to be a lot more involved in each step. And another takeaway is that there are not enough rheumatologists in this world. Kids, get educated. Go to med school, become a rheumatologist.

 

Penny Greenblatt:

And that's why I volunteer with the Arthritis Foundation also. I figure I've been dealt this really crummy disease. I always say, "Psoriatic arthritis is not a disease for sissies." But as long as I'm dealing with it, I just want to help other people deal with their situation as well.

 

Jed Findley:

Love that.

 

Sarah Cloud:

Well, thank you so much, Penny and Jed, for your time and joining us today.

 

Penny Greenblatt:

It was great talking with all of you. Thanks.

 

Jed Findley:

Thanks so much.

 

PODCAST CLOSE:

The Live Yes! With Arthritis podcast is independently produced by the Arthritis Foundation. Gifts from people like you make our podcast and other life-changing resources possible. You can donate at arthritis.org/donate. This podcast aims to help people living with arthritis and chronic pain live their best life. People like you. For a transcript and show notes, go to arthritis.org/podcast. Subscribe and rate us wherever you get your podcasts. And stay in touch!