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Online resource that helps patients better understand health coverage options, choose the right coverage, manage the denial process and reduce health care costs.
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  • About Arthritis
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    woman holding her wrist What Is Arthritis?

    Arthritis is not one disease. Learn about the different types of arthritis, how they differ and why it’s important.

    microbes Inflammation and the Immune System

    Body-wide inflammation is at the root of most chronic diseases — and you may have more control over it than you think.

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    A new arthritis diagnosis can be overwhelming. These tips can help.

    • Understanding Arthritis
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    Woman holding shoulder Webinar: Touch Therapies for Pain Management

    Learn the evidence behind popular touch therapies for arthritis, including what to try and what to avoid, for how long and when.

    Managing Arthritis Care Costs

    Learn the basics about health care costs and financial tools available to you.

    Man with head in hands on bed Webinar: Arthritis Fatigue Causes and Solutions

    Learn the various causes of arthritis-related fatigue and strategies to combat weariness.

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    Woman with upset stomach Microbiome, Gut Health & Arthritis

    Microbiome, microbes, microorganisms – these terms may be confusing, but the types of bacteria living in and on our bodies can impact arthritis. Learn what helps or harms the microbiome and the health of your gut and discover dietary changes that can make a difference. This episode was originally released on January 19, 2021.

    man exercising Stairs Workout Demo

    Strengthen your leg muscles and improve your stability to make going up and down stairs safer and easier.

    woman consoling another Arthritis and Mental Health

    Learn about the connection between arthritis, depression and anxiety and how these conditions can make your arthritis worse.

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    2023 JA Family Summit

    Learn about the National Juvenile Arthritis Conference, a place for families to connect, share and learn.

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    The Arthritis Foundation’s JA camp programs give kids with arthritis and related childhood rheumatic diseases the chance to make lasting memories.

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    Transforming Clinical Interactions

    The Live Yes! Arthritis community connects patients with others online and in-person for support and education, and encourages patients to play an active role in their health care.

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    The Arthritis Foundation recently launched an initiative to build stronger relationships and increase recognition of our most engaged practices.

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    See how we're aiming to address the growing shortage of arthritis specialists, especially in under-served parts of the country.

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    The Osteoarthritis Clinical Studies Forum Series features OA thought leaders from across the globe discussing the future of how the disease can be treated to improve patient outcomes.

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    The Arthritis Foundation is mobilizing patients and their families to engage in studies comparing the effectiveness of treatments for juvenile arthritis and funding research for more options.

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    Take action today - use the resources here to learn who your elected officials are, what opportunities we have to advocate from the comfort of your own home, federal and state legislation, and more!

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    Share your experience in a 10-minute assessment to be among those changing the future of arthritis.

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    You may have arthritis, but it doesn't have you. The Arthritis Foundation’s one-of-a-kind podcast. Hosted by patients, for patients.

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TAKE CARE: Advocacy Blog Series

Accumulator Adjustment Programs


We’re excited to present a new advocacy blog series meant to help you take care when it comes to important arthritis health care and coverage issues. Over the next two months, we’ll post a blog every other week to help patients like you know what access issues we are watching and what you can do about them. This week we’ll tell you about a new policy many pharmacy benefit managers (PBMs) are using called accumulator adjustment programs, which could especially impact people in high deductible health plans. Read on to learn more about these programs and why they are being implemented.

What are accumulator adjustment programs?


Many pharmaceutical manufacturers offer co-pay cards that help cover a patient’s portion of drug costs. Traditionally, PBMs have allowed these co-pay card payments to count toward the deductible required by a patient’s health insurance plan. With an accumulator adjustment program, patients are still allowed to apply the co-pay card benefits to pay for their medications up to the full limit of the cards, but when that limit is met, the patient is required to pay their full deductible before cost-sharing protections kick in.

What does this mean for patients?


It means that when your copayment card limit has been reached, the value on the card will not have counted toward your deductible or annual out-of-pocket maximum. Instead, you will need to pay your full deductible before cost-sharing protections kick in.

Here’s an example: It’s the start of a new health plan year in January and you are on a biologic with a list price of $3,000 a month. You use your copay card at the pharmacy and make a regular copayment at the counter. By the time March arrives, you’ve reached the limit on your copay assistance. As a result, when you go to refill your prescription in April, you will owe $3,000, the full cost of your drug, because the deductible has not yet been paid down.

For patients enrolled in these programs, we want to make sure they understand the elements of the program and are prepared to pay the full cost of their deductible should they exhaust their copayment assistance. As shown in the example above, people on expensive medications like biologics could be affected as early as this month, if they haven’t been already.

Why are PBMs and insurers using these programs?


PBMs and insurers argue that copayment assistance keeps drug costs artificially high by incentivizing patients to use higher-cost, branded drugs when lower-cost drugs are available. If a branded drug costs $100 and there’s a lower-cost alternative available for $50 – but the branded drug offers you a copayment card that covers 90 percent of the drug cost – which are you going to choose?

While this may be a valid argument in many cases, the problem is that for some therapeutic classes – rheumatoid arthritis is a good example – there are no generics or significantly lower-cost alternatives. Whatever the case, patients with chronic diseases who rely on regular access to treatments to stay healthy may be negatively impacted by these programs.

Who is enrolled in these programs?


People most likely to be enrolled in these programs are those in employer-sponsored plans and those in high-deductible health plans (HDHPs) in particular. HDHPs are becoming increasingly common as plans employers and insurers use to help incentivize appropriate health care utilization and to lower costs.

If you have been affected, or think you might be in one of these programs and want to be prepared, what can you do?



  • Consult your health plan materials or call your insurer to ask questions. If you have been affected by this type of policy and have had to switch to another drug or have been unable to fill your prescription, tell your insurer. We do not believe that insurers want to implement policies that lead to medication nonadherence. But they won’t know unless you tell them.

  • Tell your employer, too . Your employer may have adopted this program thinking of it as a cost-savings strategy without truly understanding the negative impact it could have on their employees.

  • Tell us! We want to know about your experience, so we can be better informed when we are advocating for you.

  • If you are unable to afford your prescription drugs, patient assistance programs may help. Also visit our Access to Care Toolkit for help navigating all aspects of health coverage.


We understand that h ealth care costs continue to be a complex issue for all parts of the health care industry, for employers and for patients themselves. The Arthritis Foundation family wants to be a part of the solution. We are here for you and will continue working diligently to identify solutions that put patients first.
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    Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundation’s mission.

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Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing.

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Honor a loved one with a meaningful donation to the Arthritis Foundation. We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift.

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Volunteer Opportunities

The Arthritis Foundation is focused on finding a cure and championing the fight against arthritis with life-changing information, advocacy, science and community. We can only achieve these goals with your help. Strong, outspoken and engaged volunteers will help us conquer arthritis. By getting involved, you become a leader in our organization and help make a difference in the lives of millions. Join us and become a Champion of Yes.

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Live Yes! INSIGHTS


Give Just 10 Minutes.

Tell us what matters most to you. Change the future of arthritis.

By taking part in the Live Yes! INSIGHTS assessment, you’ll be among those changing lives today and changing the future of arthritis, for yourself and for 54 million others. And all it takes is just 10 minutes.

Your shared experiences will help:

- Lead to more effective treatments and outcomes
- Develop programs to meet the needs of you and your community
- Shape a powerful agenda that fights for you

Now is the time to make your voice count, for yourself and the entire arthritis community.

Currently this program is for the adult arthritis community.  Since the needs of the juvenile arthritis (JA) community are unique, we are currently working with experts to develop a customized experience for JA families.

How are you changing the future?

By sharing your experience, you’re showing decision-makers the realities of living with arthritis, paving the way for change. You’re helping break down barriers to care, inform research and create resources that make a difference in people’s lives, including your own.

Get Started

Partner


Meet Our Partners

As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability. Join us today and help lead the way as a Champion of Yes.

Trailblazer

Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. They contribute $2,000,000 to $2,749,000

Visionary

Our Visionary partners help us plan for a future that includes a cure for arthritis. These inspired and inventive champions have contributed $1,500,00 to $1,999,999.

Pioneer

Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. They contribute $1,000,000 to $1,499,999.

Pacesetter

Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis. They contribute $500,000 to $999,000.

Signature

Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis. They contribute $250,000 to $499,999.

Supporting

Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. They contribute $100,000 to $249,999.

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