Is Psoriatic Arthritis (PsA) Covered Under Critical Illness Insurance?

If psoriatic arthritis runs in your family, you may want to consider critical illness insurance in case you receive a diagnosis.

Critical illness insurance provides a cash payout if you have certain medical emergencies and life-threatening conditions, such as:

• Certain cancers

• Heart attack

• Stroke

• Organ transplant

• Coronary artery bypass surgery

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Psoriatic arthritis is a condition that causes pain and inflammation in the skin, joints, tendons, and spine. Typically, this chronic condition is not considered a medical emergency. 

Critical illness insurance policies that cover a wider variety of conditions may include psoriatic arthritis. Finding a policy that covers psoriatic arthritis may be difficult. But, if you do, here's what you need to know.

What is critical illness insurance?

Critical illness insurance is a supplemental policy. This coverage can help you deal with the expenses that often come with the diagnosis of a serious or life-threatening condition. 

While critical illness insurance can be helpful in some cases, the Commonwealth Fund notes that these policies have strengths and limitations. 

Here are some facts to keep in mind: 

• Critical illness insurance is not primary health insurance. It is a limited plan that typically provides a one-time cash payout if you're diagnosed with certain serious conditions.   

• You can use the payout for anything, including out-of-pocket healthcare costs or household expenses.

• Critical illness insurance typically covers life-threatening illnesses such as cancer, but not chronic conditions such as diabetes.

• Though premiums are typically lower than traditional health insurance, they can rise as you age. It's not unusual to pay as little as $10 to $30 per month. Typical payouts can be $5,000 to $50,000. 

• Some companies offer critical illness insurance as a benefit.

• Policies may end when you reach a certain age, such as 65 or 70.

What does critical illness insurance cover?

Critical illness insurance policies will specify their covered conditions. Assume you won’t have a payout if you receive a diagnosis that is not listed. Make sure you ask about covered conditions before you buy the insurance. Conditions are usually serious or even life-threatening. 

Some common covered conditions include: 

• Cancer

• Heart attack

• Stroke

• Alzheimer's Disease

• Organ transplant

• Coronary artery bypass surgery

• Paralysis

Amid the pandemic, some policies have added COVID-19 as a covered condition. There are even policies that cover loss of hearing, vision, and speech. 

Does critical illness insurance cover autoimmune diseases?

Autoimmune diseases are conditions in which the body's immune system attacks healthy cells, organs, and tissues. Many have no cure and require lifelong treatment.

Autoimmune diseases aren't usually among covered conditions. But some policies provide coverage for illnesses such as systemic lupus erythematosus (SLE) and multiple sclerosis. Check the policy before you buy to make sure you know which conditions are covered.

Is psoriatic arthritis covered by critical illness insurance?

Coverage of psoriatic arthritis is not common. Insurers decide what conditions are covered in their critical illness insurance policies. While most policies will cover major health events such as heart attacks and cancer, some provide coverage for a wider variety of ailments. 

Psoriatic arthritis is an autoimmune disease. Since some critical illness insurance policies cover autoimmune diseases, you may find a policy that includes psoriatic arthritis. 

Ask if the conditions important to you are covered before buying a policy.   

What is not covered by critical illness insurance?

Critical illness insurance usually includes a limited number of conditions. Conditions that are not listed on the policy are not covered. While policies differ, common chronic diseases such as diabetes usually are not covered.

Critical illness insurance also does not cover pre-existing conditions. If a policy covers cancer, you won't be able to receive benefits if you had that same type of cancer before you bought the policy.

Likewise, if a plan covers psoriatic arthritis and you've already been diagnosed, the policy would do you no good.

Is critical illness insurance worth it for psoriatic arthritis?

Whether or not critical illness insurance has a value to you depends upon your situation. If you can find a policy that provides coverage for psoriatic arthritis, you should consider:

• Likelihood of diagnosis: Psoriatic arthritis can run in families, which can increase your chances of diagnosis.

• Premium cost: Is the policy affordable for you every month?

• Payout size: Determine how much the amount you would receive if diagnosed compares to what you’re paying every month.

• Primary health insurance plan: Your main health insurance plan may provide all of the coverage you need. If you don't think a psoriatic arthritis diagnosis will set you back too much financially, you may not need to buy a policy.

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Written by:

Tamara E. Holmes

Tamara E. Holmes is a Washington, DC-based freelance journalist and content strategist who has been writing about personal finance, health, and health insurance for more than a decade. Her work has appeared in various print and online publications, such as USA Today, AARP, Working Mother, and Diversity Woman.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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