I received a call back from my pharmacy saying that the medication is no longer covered by my insurance, which means paying $95 out-of-pocket per month instead of $25 per month.
Of course, this is not the news I wanted to hear, nor was I expecting to hear.
So I called my insurance company, and after talking to three different people, I was told that they have decided to no longer cover any compounded medications.
I explained that I have lupus and RA, and that this medication is working for me, so would they provide an exception? Of course, the answer was no.
It’s really crazy though that they covered it last month and are no longer covering it this month.
Insurance companies make these willy nilly decisions and they don’t bother to think about who they are impacting and what the consequences of such decisions are.
At this point, because the medication is working for me, it really doesn’t make sense to go off of it and try something else, even if it would mean a more manageable cost per month.
$95 a month is going to be hard to swing, along with the other medications I take costing $70 per month, and now that I am seeing an out-of-network therapist that is charging me $125 a week.
Holy credit card debt here I come. I guess that’s the price you pay for some modicum of health.
I guess I’ve always known that being on a medication that is no longer commercially available in the United States, I run the risk of just such a thing happening. But I don’t think I ever imagined that the insurance company would make a blanket rule refusing to cover any compounded medications whatsoever.
And it’s always beyond frustrating to talk to insurance companies because they just don’t get it. They aren’t doctors and they aren’t patients. They’re just cogs in the wheel of the medical industrial complex machine.
They are talking heads. They are mouth-pieces. They are simply uncaring and unsympathetic. And they put those of us who are chronically ill and in need of meds to function in a really crappy position.
I’m not there yet, but some people have to decide between eating or taking their meds. And that just shouldn’t be.
I hate it when I am forced to make decisions about my healthcare based on the dictates of my insurance company and nothing else.
I know that they are customer service people, but I really resent being asked the question at the end of the phone conversation today: “Is there anything else I can help you with today?”
First of all, you didn’t help me. You just kind of ruined my life.