EXIT Survey on Rosacea and Health Insurance Please fill out the following survey on health insurance coverage for rosacea. Results will appear in the National Rosacea Society's newsletter, Rosacea Review, and on rosacea.org. OK Question Title * 1. Do you have health insurance (including Medicare coverage)? (If you answered no, please skip to Question 6.) Private Medicare Medicaid None OK Question Title * 2. Does your insurance coverage include prescribed medication for your rosacea, such as oral or topical therapy? None Some All Don't Know OK Question Title * 3. Does your insurance coverage include laser or other light-based treatment for the redness and visible blood vessels of rosacea? None Some All Don't Know OK Question Title * 4. Are you required to obtain a referrral from your primary physician in order to see a specialist such as a dermatologist or eye doctor? Yes No Don't Know OK Question Title * 5. Have you ever had to dispute charges relating to treatment of your rosacea with your insurance company? Yes No OK Question Title * 6. Has lack of insurance coverage or the amount of your co-pay ever kept you from obtaining medical care for your rosacea? Yes Somewhat No OK Question Title * 7. Have you ever paid out-of-pocket for a rosacea-related medication or procedure that was not covered by your insurance? Yes No OK Question Title * 8. If you answered yes to Question 7, what was the amount you paid out-of-pocket for the medication or procedure? Less than $100 Between $100 and $500 Between $501 and $1,000 Over $1,000 Don't remember OK Question Title * 9. Are you: Male Female Non-binary Prefer not to answer OK Question Title * 10. Are you: Under 30 30-39 40-49 50-59 60-69 over 69 Prefer not to answer OK Question Title * 11. Comments OK Question Title * 12. Would you like to receive information on rosacea? Join the National Rosacea Society mailing list by providing your name and email below. Name Email Address OK SUBMIT SURVEY & RETURN TO ROSACEA REVIEW >>