Mental & Emotional Health

I take a particular anti-depressant known as Cymbalta.  It has really  helped me and I know that with it and the small dose of Welbutrin, I am a stable, happy person.  I’ll try to keep this short but if you’ve read here long, you know my fingers get diarrhea pretty often and just keep pecking away. 

Anyway, what I was trying to say was this, our insurance carrier made some changes to our coverage and not only were we not notified, it was as if someone slapped me in the face when I went to get my Cymbalta prescription filled. 

I take a fairly high dose of this medication and because of that we have had to have prior authorization from the insurance.  I had the authorization for 120 mg a day through last February.  It took until May for the doctor’s office and the insurance company to get it together to issue another authorization. 

But, even when I went to get the medication filled in July, it was not taken care of like it should have been.  So, I took a copy of the letter from the insurance company to the pharmacy.  The pharmacist was one of my best buddies in high school.and she called the insurance company and got the prescription and authorization  straight. 

Now, in the interim, my doctor would give me enough samples of the cymbalta so that I didn’t have to buy them out right.  At first the insurance company was going to let me have 60 capsules but only if I paid  2 $35 co-pays.  That’s when the doctor started giving me a 30 day supply and I would fill my prescription for the other 30 at 30 bucks a month.

Then, one day it was $35 for the co-pay.  And then, then the bottom fell out because when I picked the medication up last week, the lady said, $60.  I almost flipped my lid.  I paid it because what else was I suppose to do on a Saturday.  I was just planning to call the pharmacists and ask her about it. 

By the time I got around to calling her, she had already called my insurance company (it is good to have friends) and they informed her that I did indeed have an authorization for 60 pills (which is what I got for the 60 bucks) but that my co-pay for non-formulary drugs had gone up to $60.

I did flip when the words came out of her mouth.  I almost lost control of myself.  That’s freakin’ ridiculous ya’ll.  I know the medication is expensive.  I know I’m lucky to even have insurance when many people who need anti-depressants and anti-anxiety drugs do not.  I know I am lucky that my husbands employer pays the entire premium for us.  I know. 

But, regardless of who it is paying the 60 bucks, someone insured or someone who is having to fork out the entire amount, the price of medication is ridiculous.

So, when I go back for my visit, which is sometime around the end of September, I fully intend to ask that he change my mediation (although it has taken 4 years of tweaking to get it just right) because honestly, $60 is just not going to happen. 

Are you insured? 

If not, do you pay out of pocket?

If you are insured, are your co-pays decent and predictable?

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