Insurance Companies! You have to love them, right?

Frustration on insurance

My insurance company doesn’t want to cover my new medication. Even though it’s on their approved list of meds just like Trintellix was. It has to be under a certain diagnosis code, and I have to have failed a certain amount of medications before they’ll cover it under a prior authorization.

Guess what, insurance company? I’ve literally failed at least EIGHT medications, if not more. And that’s mostly within the last 3 years. So, my psychiatrist’s assistant called me back and listed off medications that they want me to have tried first. I told her yes to pretty much all of them (I hadn’t tried 2 of them, which was actually a surprise to me), and when I had tried them. Most of them had been tried with that specific psychiatrist, when on this insurance, but two of them were tried years ago and didn’t work then either.

So, I guess we’ll see. I’m really hoping that they’ll cover the Viibryd, because honestly, it’s WORKING! And the incredible thing is, it’s STILL working. Too many of my medications start working at first, but very quickly stop. But it’s been a month. And I’m loving it.

Why is it that insurance companies seem to think they know better than the psychiatrist? That they know my needs better than the person actually looking after my needs? Because they’re just a bunch of bureaucrats sitting around a table, hoping that they don’t have to spend more of the money I’m giving them anyway.

Don’t get me too wrong. As far as insurance companies go, mine’s not terrible. My copays for generic medications are $0, my copay at the doctor’s office is $0, and even specialists are only $5. Even the deductible is pretty low.

But when it comes to mental illness drugs, insurance companies don’t understand what they’re doing. I would go so far as to say they don’t understand most of the pharmacy side of things. Insulin is getting more and more expensive, though I think the outrage for it got so bad it’s being fixed a little. This article is a little out of date, from Jan of 2021, but it’s still pretty bad.

I guess this is one of the reasons I do what I do. The outrage at insulin prices was nationwide, but where’s the outrage when it’s this difficult to get the right mental health medication? Where’s the walks, the signs, the protests? Why is it that people can’t seem to get on board with mental health medications like they can with physical ailment medications. The lack of both can kill you. One’s just more obvious.