Written by Melinda
Friday, February 12th, 2010
I’ve been just a little bit distracted lately. Several weeks ago I had an appointment with the gynecologist for another ultrasound. The cyst on my right ovary is almost gone. Great news! While there, I spoke with them about my depression and how I needed some other type of medication. He was very hesitant, given the nature and history with my gastric bypass surgery, to prescribe anything that may cause weight gain. So, we came up with a conclusion: How about trying BRAND NAME WELLBUTRIN instead of generics? I’ve tried 3 different brands of generics and they don’t seem to be cutting it.
I dropped my little prescription off at the pharmacy, and no sooner had I made it back to my desk (there is a pharmacy where I work, and I had walked across campus), I had a message to call them. The pharmacist said that there is a “Dispense as written” penalty on my policy, and MY co-pay for a 90 day supply for brand name Wellbutrin would be almost $700. I won’t go into the many things which occurred as a result… but to make a long story short, the gyn wrote a letter of medical necessity at the insurance company’s prodding but they said they still would not pay more towards the brand name.
All I can say to you is that I never realized how much anger and frustration was pent up inside me, all 5′4 worth. As I spoke to the insurance company one day, I could feel the anger rising up from my gut, until it built like an erupting volcano and I spewed out insults and shouts at the lady on the other end. I must admit, I feel horrible about it now. And, while I didn’t insult her on a personal level, I should not have spoken so harshly and ugly with her. I couldn’t help it. I was so angry inside because of the state this country is in when it comes to health care. And, I THOUGHT I had a great insurance policy. Now I see that it too is regulated very tightly and it makes me mad.
I think this was actually the icing on the cake. I was already upset because my insurance had denied my Ortho Evra birth control patch that I needed to help with hormone problems. I work for Catholics and they don’t believe in birth control/contraceptives. So, they refuse to pay for it under our health policy. Each and every year, I am forced to have my gyn write a letter of medical necessity. I’ve now paid two months out of my pocket because they were not processing my information.
A second factor that upset me to no end was that they paid for my Mirena IUD insertion in May 2008, but denied its removal at the end of December. I came unglued on the phone with the representative over this one. I’m still waiting and checking their website daily to make sure they correctly processed the claim. I really don’t know how your average person does it… thank heavens I have some knowledge of billing, insurance collections, hospital and medical health claim processing… or else I would be left paying it all out of pocket and not knowing how to fight it.
So, angry and upset over these three issues with insurance, I’ve come to a conclusion. Even if I did take the brand name Wellbutrin, I’d end up depressed due to being BROKE after paying $700 out of my pocket. Or, if I took their suggestion and took Lexapro AGAIN, my depression MAY go away, only to return after gaining back weight from the food obsession that it causes me!
In the meantime, I’ll just keep taking my little generic pill and hope that it gets better. I do see my therapist Weds. in hopes of receiving some sort of direction on “Where to from here?” Don’t you wish there really was a such thing of a magic pill, and all our troubles could just vanish?
