I have suffered from psoriatic arthritis (PA) since I was 15 years old. It started in my feet. I was misdiagnosed for 4 years. Everything from being told I walked wrong on my feet and had to have special shoe inserts made to being told I had a hairline fracture in my foot and being placed on crutches for several months. When I turned 19 and had to get on my own health insurance I saw a new primary care physician who had an office out of his home and used smuckers jelly jars to hold his tongue depressers, he diagnosed me with PA within 10 minutes. The identifying characteristics were pitting in my finger nails!! I only ever really had mild psoriasis on my scalp which I do not have any symptoms of today yet the PA still plagues me. Over the years I have had multiple surgeries. The first was on my feet. I have had all of my toes fused with exception to my big toes. I have had the Darache procedure (where the disal ulna is removed) done on both wrists. That procedure did not help so in 2003/2004 I had both wrists fused. That means I have a rod that starts at the base knuckle for my middle fingers running up my forearms. I can no longer bend my wrists back or forward. I still have rotation (palm up/palm down). I have also had my right thumb fused at the joint which connects it to the palm and less than 2 months ago had my left ring finger fused at the middle knuckle. Prior to the fusion of this finger I had a synovectomy which never healed properly and caused a self fusion where my finger was bent at a 90 degree angle....that is the picture of my hand I have posted here prior to the recent surgery. I also have had multiple in office procedures done from joint injections with steroids during flare-ups, epidurals and floroscoplically guided injections in my Sacroiliac joint (SIJ) on the right side. I have a ruptured L4/L5 disc and arthritis in my SIJ. That is what took me out of work for good back in 2005. Applying for SSD alone was a full-time job that took 2 years to get approved after appeals. I recently lost the health plan I was on and am now strictly on Medicare. Or as I prefer to call it Medi(don't)care. I also for the first time had to enroll in a Medicare Part D plan, what a JOKE!!!! The coverage is so limited and there is a gap or doughnut hole where my out of pocket expenses are predicted to be over 5k just for medications and that is WITH the Part D plan!!! How is someone supposed to survive on an SSD income, pay Medicare deductibles, 20% co-insurance and >5k a year on medications used to control their disease and pain??? I am applying for help with some of my medicines through the drug companies. However most of them say that I earn TOO much, I make 20k a year and my Enbrel alone is $1,400 a month!!! Then I was told by Enbrel's Encourage Foundation (who helps get you the Enbrel without cost or little cost) that in order to qualify for any grants, etc. I had to enroll in a Part D plan, now I am being told that I do not qualify for medicines to be donated because I HAVE RX coverage under Part D, and they only donate to individuals that have NO coverage for RX's. If I do not continue to take disease modifying medications like Enbrel my PA will get worse and cripple me. I am 38 and could be facing a wheelchair in the next 4-5 years. I do not understand WHY our country chooses to limit access to adequate healthcare and medications. Medicare won't cover RX's yet they govern the Medicare Part D plans offered through different insurance carriers. Sounds really fishy to me and I worked for a health insurance company for 3 years and in insurance in general since I was 18!!!! If anyone has ANY advice on how to gain access to medications at a lower rate, or if it is possible to supplement your SSD income and NOT reduce your SSD payments or send red flags to SSD I would truly be greatful. Thanks!