The Value of Making Long-Term Rheumatoid Arthritis Care Plans

Rheumatoid arthritis is an autoimmune condition that causes inflammation in your joints, leading to symptoms like joint pain, swelling, and stiffness. In simple terms, your immune system attacks your healthy tissues.

If rheumatoid arthritis is left untreated, the condition can damage your joints and impair your ability to perform certain activities. It is in your best interest to make a long-term care plan that will not only slow the progression of your disease but will also keep you financially secure.

This article will discuss what aspects of rheumatoid arthritis may contribute to needing a long-term care plan, making a long-term care plan, finding support, and options if you don't have insurance.

Aspects of RA Care That Can Last Long Term  

Rheumatoid arthritis is a progressive disease, meaning that it will likely get worse over time. While treatments can help to protect your joints, there is no guarantee they will work for you, and these treatments do not cure the disease. With that in mind, it’s important to understand what you can expect the longer you have the condition.

Fatigue

Because your immune system is not working correctly, your whole body, not just your joints, could be affected. One of the most common systemic symptoms—those that involve your entire body—is fatigue. This fatigue is more than just being tired. It can be better described as exhaustion that impairs your ability to function. It can affect your quality of life too.

According to a 2018 study, as many as 75% of people who have rheumatoid arthritis also have clinically significant fatigue. They have it at a rate 4 to 8 times more than people who do not have the condition. This fatigue can sometimes be associated with difficulty concentrating and depressive symptoms.

Chronic Pain

Rheumatoid arthritis starts by attacking the synovial membrane that lines your joints. It eventually wears down your cartilage, and ligaments, and can even break down bone.

Your joints may become swollen, stiff, painful, and warm to the touch. Nodules (firm lumps) can form under the skin. You can develop deformities in your hands and other joints.

All this inflammation and joint damage can lead to chronic pain. This pain can decrease your ability to perform certain activities. Medications used to treat pain could potentially be sedating or have other side effects that could pose their own problems.

Mobility Difficulties  

The more damage that occurs to your joints, the stiffer and more painful they can become. As the joints change shape, they may become more difficult to move and control.

This could make it challenging for you to open medication bottles or perform other fine-motor tasks. It could become difficult to climb stairs, stand for long periods of time, rise from a chair, or get out of a bathtub.

Walking (even short distances) could become more challenging during a flare-up (times when symptoms worsen or new symptoms appear). That is why many people with RA sometimes use canes or wheelchairs. You may need to plan how to improve safety within your home with mobility limitations.

Self-Care Routines  

RA is not a condition you should manage on your own. You should see a rheumatologist (a specialist in rheumatologic diseases), who can help track your symptoms and treat you with medications that can slow the progression of your disease.

There are things you can do for yourself too. Consider these self-care routines to decrease your risk for flare-ups:

• Eat healthy: Foods rich in antioxidants and omega-3 fatty acids have anti-inflammatory effects. They may help keep your RA symptoms at bay. Some studies show benefits from the Mediterranean diet too.
• Get enough sleep: The fatigue from RA is enough on its own without the added exhaustion from sleep deprivation. Do your best to get seven to nine hours of sleep every night.
• Keep moving: Physical activity that keeps the joints moving can help to keep them limber and decrease stiffness. Consider stretching exercises and activities like yoga.
• Maintain a healthy weight: Increased body weight puts more burden on your joints. It is also associated with lower rates of remission from RA. Keep your weight down, and you might be able to better manage your symptoms.
• Take breaks: It’s OK to take a break when you need one. If you push yourself too hard, you could increase your risk for flare-ups.

Adjusting Your RA Medications

Treatments for RA can get expensive. While some medications have more affordable generic options, many of the newest treatments are available only as more pricey brand name products. As an example, AbbVie Inc. reports that a 30-day supply of its RA medication Rinvoq (upadacitinib) costs about $5,670 for people without insurance.

A PLOS One longitudinal study published in 2021 tracked healthcare costs from the time of RA diagnosis onward. Costs were as high as $8,591 the first year and were only marginally decreased to $8,135 eight years later.

That study was based in Canada, where there is national health coverage. In the United States, costs can be much higher, especially for people needing biologic medications. A 2018 study in Arthritis Care & Research showed annual costs ranging from $12,509 to $36,053.

It is important to think about how you will be able to afford the treatments your body needs to stave off worsening symptoms. That requires planning ahead.

Making a Long-Term RA Plan 

The longer you have RA, the harder it may be to perform the same work you used to do. That could affect how much income you have during your retirement years.

One study published in 2008 found that as many as 35% of people had to stop working due to disability within 10 years of their RA diagnosis. Rates of disability have been trending downward, and newer treatments could reduce these further.

It may be helpful to think about how you would manage your finances if you need to retire sooner than you’d like.

Meet With a Financial Adviser 

The first step is to ensure you have your financial affairs in order. Meeting with a financial adviser can help you strategize your approach. They can give you tips on how to budget your money, pay down debts, maximize your current savings, and invest funds when and if you can.

Life Insurance Considerations 

If you want life insurance, you can obtain it best if you sign up for a plan before or soon after you are diagnosed.

That is because these policies use a process known as medical underwriting that allows them to increase your rates or deny coverage based on preexisting conditions. The more symptoms you have, the less likely they are to provide coverage at a reasonable rate, if at all.

You will have to decide what type of life insurance works best for your budget and your needs:

• Term life insurance: By definition, this kind of insurance protects you for a limited term, typically a set number of years. As long as you pay your premiums, the plan pays a benefit to your survivors when you pass away. This can help them deal with funeral expenses and any debts relating to your estate. This sort of insurance does not build cash value.
• Whole life insurance: This kind of insurance lasts as long as you live and builds cash value over time. You can borrow against that value or even withdraw funds while you are still alive. Premiums for whole life insurance cost significantly more than a term life policy and may not be affordable for everyone.

Stretch Savings When Possible

It may be in your best interest to work as long as possible but that may not always be in your control depending on how your RA progresses. While you are still working, set aside a certain amount of your income each paycheck. Put that money into a savings or other investment account. Even a small dollar amount will grow into significant savings over time.

A budget can make a big difference too. Knowing how much you can spend will prevent you from going beyond your means. Plan your shopping lists. Shop around for the best deals. Eat and prepare meals at home. Avoid late fees and extra charges. Better yet, pay in cash when you can rather than using a credit card.

Every purchase counts, so make sure you are buying things you need, not just things you want.

Research Assisted Living and Other Care Options

Not everyone will have the ability to care for themselves as their RA progresses. They may need help and may not have family or loved ones who can support them. You may want to research the options available to you if you need in-home care or residential care.

A residential care home (board and care home or group home) is a small facility (usually 20 or fewer residents) where you have a room, personal care support, and meals. The staff is available on site around the clock, but no nursing care or medical care is provided.

Assisted living is usually a facility with more than 25 residents. These facilities may have a range of care options. Nursing homes (skilled nursing facilities) provide care for those with medical needs.

Continuing care retirement communities have a range of living options, from fully independent living to assisted living to skilled nursing care, all in one campus.

Research facilities in your area that will meet your needs. You may want to consider moving to an area where you have more options. Look into how much the facilities cost, their quality scores and ratings, and how well people fare who live there.

Consider that most health plans, with the exception of Medicaid, do not cover long-term care options such as in-home care, assisted living, or nursing home care. This is why some people turn to long-term care insurance plans. These plans specifically cover care you receive in a long-term care facility, like assisted living or a nursing home.

Because of medical underwriting, it may be difficult to qualify for this kind of insurance after you are diagnosed with RA. It is best to enroll in one of these plans when you are younger to get a more affordable rate and before you are diagnosed with any significant illnesses.

Your Support System Is There to Help 

You are not alone. Rheumatoid arthritis affects more than 1.3 million people in the United States. Thankfully, there are resources available for you and those who support you to get the help you need.

Medical Organizations

The following organizations can provide you with reliable information about rheumatoid arthritis, its symptoms, treatments, and ongoing research:

• American College of Rheumatology
• Arthritis Foundation
• National Institute of Arthritis and Musculoskeletal and Skin Diseases
• Rheumatoid Arthritis Foundation
• Road Back Foundation

Online Communities

Talking with people experiencing what you are going through may help you get through hard times. Find a group you are comfortable with and that fits your needs, such as the following:

• Daily Strength: Rheumatoid Arthritis Support Group
• Healing Rheumatoid Arthritis Naturally Support Group
• Healing Well
• Health Boards: Arthritis
• My RA Team
• RA Connection
• Rheumatoid Arthritis Support & Awareness
• Rheumatoid Arthritis Forum 

Rheumatoid Arthritis With No Health Insurance

Health-related expenses can add up quickly. If you do not have health insurance, you might want to see if you can find an affordable option, including:

• Healthcare Marketplace: The Healthcare Marketplace was created by the Affordable Care Act to provide reasonably priced care. If you sign up for a plan, you could be eligible for subsidies that can lower your monthly premiums even more.
• Medicaid: Medicaid is a state-run program partially funded by the federal government that aims to provide health care to low-income individuals and those in medical need. Check with your local Medicaid office to find out if you are eligible.
• Medicare: You may qualify for Medicare at age 65, but you could also enroll if your RA qualifies as a disability by Social Security or the Railroad Retirement Board. To keep costs down, you can check to see if you meet eligibility for one of the Medicare Savings Programs to help pay down your premiums, deductibles, coinsurance, and co-pays. You may also qualify for the Extra Help Part D Low Income Subsidy for your prescription medications.

You may also want to reach out to charitable groups to keep your healthcare costs down. The following nonprofit organizations may be able to decrease how much you pay for prescription medications and other health-related expenses:

• Creaky Joints
• Good Days
• HealthWell Foundation
• NeedyMeds
• PAN Foundation

Summary

It can be difficult to perform certain activities when your RA gets worse or when you have flare-ups. The goal is to plan ahead by taking care of your health and your finances. Your goal should be to get well, not to worry whether you can pay for your care when the time comes.

Follow up with your healthcare provider and take your medications as prescribed. Incorporate self-care into your routine, and treat your body to healthy food, quality sleep, and regular exercise. Building a support network, in person and online, can help you cope during difficult times.

Stick to a financial budget and build on your savings whenever possible. This could mean working with a financial planner, budgeting, cutting expenses, and looking into different insurance options, whether it’s a health plan, life insurance policy, or a long-term care policy. You may need to turn to them on a rainy day.

Finally, don't forget to look into federal subsidies and other discount programs that can help reduce your healthcare costs.

A Word From Verywell

Rheumatoid arthritis certainly can take a toll on your physical and mental health, but it can affect your financial health too. It’s not always easy to think about these sorts of issues but planning ahead could help you live your best quality of life, regardless of the circumstances. You deserve it.