What are your rights?
Gastroesophageal Reflux Disease (GERD) is one of the most common health problems facing adults in this country, but there are no federal acts in place to ensure that patients receive treatment.
What problems might you run into?
Many acid reflux medications are now over the counter, meaning that they aren’t covered by insurance prescription plans. However, prescription-strength medications, procedures, and surgeries used to treat GERD are typically covered by standard insurance plans. Call your insurance company to make sure that your doctor is within network and your treatment is covered before making an appointment.
How can you save money on treatment?
“The best way to save money treating acid reflux and GERD is to make lifestyle adjustments,” says Dr. Prateek Sharma, professor of medicine at University of Kansas School of Medicine. “Those actions cost nothing and can drastically reduce how much medication you need or even result in your taking no medication at all.”
First, you should pay attention to the kinds of food that trigger your symptoms. For example, does eating Mexican food or pizza cause them to appear? Next, try reducing your intake of that specific type of food or avoid it completely. This step alone may reduce your symptoms to the extent that you won’t have to buy medicine anymore.
In addition to dietary changes, Dr. Sharma says that you should make sure to sit upright for two to three hours after your evening meal and avoid eating for two to three hours before bedtime. “These are simple, free ways to keep your symptoms in check,” he says. “Don’t immediately think you need to visit doctors and get prescriptions or over-the-counter [OTC] drugs if you have GERD.”
You can try OTC antacids like Mylanta, Tums, or Rolaids if you’ve tried those changes but are still having symptoms. These medications aren’t too pricey, and if you’re only taking them every now and then, they won’t make too much of a dent in your wallet. “If those don’t work though, you’ll have to move on to proton pump inhibitors (PPIs) and H2 blockers.
These are all available over the counter as well, and if you only need to take them infrequently, they can be relatively inexpensive,” says Dr. Sharma. “Quite a few are available in generic [forms] and are just as good as name brands like Zantac.”
He also suggests searching online for coupons for those drugs before heading to the store. If none of these options work, then you need to see a gastroenterologist, who can help come up with a treatment plan. Depending on your situation, this might include prescription-strength PPIs, a procedure similar to endoscopy (an examination of the lining of the esophagus and stomach), or a surgery called fundoplication.
These procedures and drugs are typically covered by insurance. However, they can be expensive if you don’t have insurance. Ask your doctor for a discount on services if you pay cash up front. Then, go to the Partnership for Prescription Assistance’s website (pparx.org) for advice on applying for financial assistance.
Dr. Sharma says another option is to look for different clinics in your area. “I’m in Kansas City, and we have a clinic for the uninsured and underinsured through the University of Kansas,” he says. “Contact local health officials, or do a search online to see what your options are.”