Medication and Insurance
By carpenter5
@carpenter5 (6782)
United States
May 13, 2009 1:27am CST
This afternoon, I went to the pharmacy to pick up the prescription for my anti-depressants. I've been on Lexapro for several years. I've tried to quit taking them, but after several months of being without the medication, my family is begging me to go back to the doctor. I have clinical depression and I got hateful and mean one minute and crying the next.
Anyway, to get back to my story of this afternoon, I walk into the pharmacy and she starts looking for my prescription and can't find it. The pharmacist walks out from behind the counter and calls me over to the end away from the rest of the customers. He proceeds to tell me that my insurance company has denied payment of my Lexapro because they want me to use something else. He named another anti-anxiety drug that I've tried before. I don't like the way it makes me feel, and told him that I couldn't take that. It made me feel jittery and like I wanted to crawl out of my skin.
I called the doctor who promised to try and make the insurance company see that I needed the other medication. They offered it at a higher co=pay which is more than the medicine itself cost! How retarded is that?
So my choices are to pay regular price ($37.oo for a 30 day supply) or pay the $50 copay (Does this not make sense to anyone else?) or go to another medication.
In the meantime, I'm out of medication until we figure o ut what to do.
Dr. Stout is still trying to get something worked out. He told me to come by in the morning and he thought he had some samples until we could get it all straight.
Has this ever happened to you? How can the insurance company decide what is best for me and my body if it goes against what my physician wants?
3 people like this
5 responses
@Shaun72 (15959)
• Palatka, Florida
13 May 09
Yes it has. There have been quite a few medications that my doctor prescribed for me that my insurance wouldn't cover. It gets really frustrating to me as I am sure it has to you also. I use to be on Lexapro myself and the way I have been feeling latley I might ask for it agian. My insurance wouldn't cover it before. There are a lot of things that it is not covering. Like the last time I went to see my doctor I asked for some nasal spray I have sinus problems really bad. It wasn't covered and I couldn't afford what the cost was so I bought something over the counter that seems to do pretty well.

@carpenter5 (6782)
• United States
18 Jun 09
Thank you my friend. That really means a lot to me to know that you are all praying. I'm not sure what God is trying to show us or teach us, but we will know when he is ready to reveal it. I am getting some great advice from many that I'm learning to heed...I'm taking a baby step onto the brick in the path that God has lit up for me. When he is ready for me to move, he will light up the next one. I'm not supposed to see the rest of the path yet. I have to learn to trust him.
@Shaun72 (15959)
• Palatka, Florida
19 Jun 09
It is hard to trust God. Even I have a hard time myself. After all the ups and downs that I have been through in my life. Although I know everything happens for a reason.Good and bad. I just know to keep my faith and pray and trust in God.
1 person likes this

@GardenGerty (169474)
• United States
15 May 09
Pam, I certainly hope you can help her. Sometimes it is only a person who has been there who can show the next person the way out.
2 people like this
@carpenter5 (6782)
• United States
21 May 09
Here's the latest scoop. We did end up switching medications. #1 because the insurance company was giving us such fits. #2 because there were some other things going on that I didn't realize were side effects of the Lexapro. (Things between Mike and I had come to a screeching halt)
1 person likes this
@AmbiePam (120738)
• United States
21 May 09
Yep, that's a good reason to find another one.
Also, there is this thing called RX for Oklahoma - Prescription Assistance Program. I'm think there has to be something like this in your state. The program is in cooperation with the Central Oklahoma Community Action Agency. I ended up not having to use this, but one of my uncles did. If you have any further trouble, maybe there is something similar near you. They would pay for several medications if one could not pay themselves.
1 person likes this

@spicysweetie21 (2572)
• United States
20 May 09
I have had a similar experience too except the medicine wasn't a depression medicine, a few years ago when I was still a teen and on my fathers work medical insurance they decided that the insurance wouldn't cover my daily inhaler, I have pretty bad asthma so i had to have the daily inhaler, i had tried lots of other kinds but that kind was the only one that really worked....the daily inhaler cost $90 for a two month supply and at the time all that was available was the two month supply,,,my parents couldn't afford it so i switched to a generic daily, but that meant i had to use my rescue inhaler more often...so in the end we still got screwed until my dad got another job and got different insurance....i just know exactly what you mean about being taken advantage of by insurance companies, yours is worse than my story though because depression medicine is way trickier and more individualized than asthma medicine, i hope it all gets worked out for you
1 person likes this
@carpenter5 (6782)
• United States
23 May 09
It will all work out in the end. I'm three days in to a new medication and so far, so good. It seems to be working as well as the Lexapro. I'm told it's virtually the same medication by a different manufacturer. It would be nice if it were to work well without all the hunger and other side effects the Lexapro had! I know hubby is tired of me getting hungry for peanut butter and jelly sandwiches at 2 a.m.~! LOL
@kawalnarang (1095)
• Trinidad And Tobago
13 May 09
I feel ur pain,, but I believe the doctor is the best man to advise u
@carpenter5 (6782)
• United States
18 Jun 09
OH dear friend, I wouldn't dream of making a decision about medication with consulting my doctor. Too many bad things can happen. I have a friend who is bipolar and she decided about 6 months ago that the medicines the doctor had her on weren't working and she went off them on her own and tried some herbal home remedy that this man who came into the store where she worked...convinced her would work better.
Well, she ended up going off the deep end, put her 6 year old baby in the car and wrapped it around a tree trying to escape from a demon that was chasing her.
@besthope44 (12123)
• India
8 Oct 10
Well for depression, medicines are not solution. Do Meditation, try breathing exercise, it will help you balance and handle depression.
1 person likes this
@carpenter5 (6782)
• United States
5 Dec 10
While these are good ideas, many cases of depression (Including mine) are caused from a hormonal imbalance. Deep breathing is not going to cure this, any more than it would cure cancer. Sometimes, medication is necessary.





