Tips for dealing with changes to asthma management

Asthma affects millions of people, and inhalers are the most common way to manage the condition. For many patients, daily maintenance inhalers help control inflammation, while rescue inhalers provide quick relief during flare-ups. When used correctly and consistently, these medications can make a major difference, helping people breathe easier, stay active, and avoid emergency care.

Having access to the right inhaler (and knowing how to use it properly) is a key part of staying well. But at some time, you may be (or have been) told that this vital medication needs insurance re-approval, isn’t covered anymore, or has been switched to a different option. These changes can feel frustrating or even scary when one's treatment is working well to control flares.

Why do inhaler coverage changes happen?

Insurance plans update their medication lists (called formularies) regularly. These changes are often based on cost, availability of alternatives, or updated agreements with drug manufacturers. Sometimes this leads to a different inhaler being preferred or a need for prior authorization (extra approval from your doctor). There may also be higher out-of-pocket costs for certain brands.

If you find out your inhaler isn’t going to be covered or requires extra approval, your first step should be to talk to your doctor. Your provider can confirm whether your current inhaler is still the best choice for you and then submit paperwork to your insurance company attesting to the need.

If coverage is denied, don’t assume that’s the final answer. You have the right to appeal. This usually involves the prescribing doctor submitting additional information and also explaining why other options may not be as effective.

If an inhaler change does occur, have the pharmacist show you how to use it and then practice using it correctly. If it feels confusing or uncomfortable, speak up. Using the wrong technique can make an inhaled medication seem like it’s not working. Even small differences in how inhalers deliver medication can affect how well they work so monitor any breakthrough symptoms closely. Keep track of things like how often you use your rescue inhaler, any increase in coughing, wheezing, or shortness of breath, and whether the new inhaler feels easy or difficult to use.

Being proactive

During open enrollment or when your plan changes, take time to review your plan’s drug list and look up your inhaler or medicine to see if it’s covered. This can help you avoid surprises at the pharmacy. There may also be options for cost support (savings cards) available from manufacturers. Your pharmacist or doctor’s office can likely provide more information on how such programs can be accessed.

Looking ahead, for people with moderate to severe asthma (especially when symptoms are difficult to control) newer therapies like biologic medications are becoming more common. These are typically given as injections and are designed to target specific parts of the immune system involved in asthma. Ongoing clinical trials are also exploring additional non-inhaler options that may offer longer-lasting relief or work differently than traditional treatments. While inhalers remain the foundation of care, these emerging therapies are helping expand the options available to patients over time.