Financial Health Spotlight: Covering the Costs of Asthma

In addition to the costs of medication and doctor visits, asthma can come with unexpected financial burdens, such as lost work hours.

Asthma is a chronic lung disease that affects 1 in 12 Americans (about 25 million people), according to the Centers for Disease Control and Prevention (CDC) .

While there’s currently no cure for asthma, treatment can help manage symptoms such as shortness of breath, wheezing, and coughing — but these therapies come with a price.

Living with asthma can involve direct costs such as paying for office visits, outpatient care, and emergency care, as well as indirect costs related to missed work. Here’s a look at some of the costs associated with treating asthma, and ways you can manage these expenses.

The cost burden of asthma varies from person to person and can depend on factors such as severity of symptoms, the medications you take, and whether you have insurance.

It’s estimated that about 15.4 million people in the United States receive asthma treatment each year, according to the American Journal of Managed Care (AJMC). Individually, those living with asthma spend on average about $3,266 a year. This includes, on average:

• $1,830 for prescriptions
• $640 for office visits
• $529 for hospitalizations
• $176 for outpatient visits
• $105 for emergency room care

Some prescriptions, such as those for inhalers, nebulizers, and oral pills, are expensive, and insurance doesn’t always cover the entire expense. Also, emergency care and hospitalizations related to asthma attacks can further increase the out-of-pocket cost.

The cost of managing asthma isn’t limited to office visits, outpatient care, and prescriptions. Asthma can affect other areas of life, too, so you might have indirect healthcare costs.

Everyday asthma symptoms or an asthma attack can lead to missed work, which can reduce wages and result in missed opportunities. Even when a person is able to work, symptoms such as fatigue, coughing, and shortness of breath can reduce productivity.

According to the AJMC, people with asthma miss 1.8 days of work annually. This can result in a loss of $214 in wages each year.

In severe cases, asthma can make it difficult to work altogether or make it impossible to complete certain types of jobs.

Some workplaces can also trigger symptoms. This can happen when exposed to bothersome fragrances or chemicals on the job, or when an occupation involves exertion.

Some employers may take steps to accommodate employees with asthma. For example, they may improve ventilation and air filtration in their buildings or reduce the use of fragrant materials and scented cleaning products.

If you’re unable to manage occupational asthma, switching employers or job duties might improve symptoms in the long term.

There are a number of ways you can find help to cover your asthma treatment expenses.

Compare health insurance plans

Health insurance is a common way to cover expenses related to managing asthma. Insurance will typically cover expenses such as

• office visits
• prescriptions
• outpatient care
• emergency care

But while most health plans provide coverage for asthma, this coverage can vary by provider. Some insurers only pay for certain treatments or medications, or they’ll only cover these therapies up to a certain dollar amount.

Therefore, shop around and compare plan benefits before choosing a policy. If you’re prescribed a certain inhaler or another prescription, make sure the health insurance provider covers this particular treatment.

It’s also important to understand your out-of-pocket costs before choosing a plan. Along with your monthly premium, you’ll likely have copays, annual deductibles, and coinsurance.

Ask about generics

If you’re having trouble affording your asthma medication, you may consider speaking with your doctor or pharmacist. They may be able to recommend a less expensive option for you.

You can also ask whether there’s a generic version of your current medication. A generic contains the same active ingredient as its brand name version. It’s just as effective but may cost you less out of pocket.

Look into financial assistance programs

You can also take advantage of programs designed to reduce your out-of-pocket medical costs. Options include:

• Drug assistance programs: Some drug manufacturers offer prescription assistance programs to help individuals who can’t afford their medications. If eligible, you can receive free or discounted prescription drugs. Ask your doctor about programs you might qualify for.
• Prescription discount programs: You can also take advantage of discount programs that let you compare and save on select prescription drugs. These include GoodRX, Walgreens RX, Kroger RX Savings Club, and Walmart’s $4 Prescriptions.
• Charitable patient assistance programs: You may be able to apply for financial assistance from charitable or nonprofit foundations. If you qualify, you may be able to use funds for a variety of out-of-pocket costs, including medications, doctor visits, health insurance premiums, and travel expenses. You can register with the Patient Access Network Foundation’s FundFinder to get alerted when charitable patient assistance programs offer financial assistance for asthma.

Other resources to find financial assistance include:

Navigating asthma care without health insurance can be challenging, and some people might not seek treatment due to the cost.

In addition to drug assistance programs, discount programs, and other resources, some free community health clinics might provide asthma care to those without health insurance. This could be an option for follow-up care or to receive a low cost prescription.

Another option is scheduling telehealth appointments with a doctor to discuss concerns and get a prescription refill. This can be more cost-effective than in-person office visits.

Also, if you can’t afford a bill, speak with your provider’s billing department and ask about financial assistance. Some facilities might recommend programs or provide other assistance, such as discounting your bill or offering an affordable payment plan.

If your child doesn’t have insurance, they might be eligible to receive assistance through the Children’s Health Insurance Program (CHIP). This government-sponsored program provides lower income families with low cost health insurance to cover children and teenagers.

If asthma affects your ability to work, you might qualify for Social Security Disability Insurance benefits.

Living with asthma can have a huge impact on your personal finances. There’s the financial burden of paying for office visits, medications, hospitalizations, and emergency care. Asthma might also affect your ability to work.

If you need help paying for asthma care, you have a number of options, including applying for financial assistance programs. To learn about programs available to you, speak with your doctor or health insurance provider.

Last medically reviewed on March 22, 2023