Once you are on a Special Issuance Medical and assuming it remains that way, you must be prepared to provide whatever documentation the FAA requires and in the format requested. And yes, it will cost you considerably more money to get your medical each year. Often times insurance will not cover what the FAA requires, simply because it is not standard protocol but part of the FAA requirement. I have found that the FAA is pretty good on issuances once you provide them the pertinent documents/reports and meet the criteria for special issuance. AOPA medical has very good reviews and probably a good idea to join just for that reason. Airline Unions usually will have a free service for union members.