I’m going to break my rule again today and talk about meds openly. I’m doing so because saying Med1 does this and Med2 does this, would get too confusing.
Primarily I’ll talk about Abilify. I’ve been taking it for years and have been happy with it. There are many reasons for taking Abilify, but I primarily give it credit for reducing my hallucinations. While I miss seeing the silly donkey standing in my living room, it’s probably best I don’t see him, or any of the other animals, occupying my residence.
Abilify was fine until about 5 years or so ago. (could have been 3 or it could have been 7. I don’t know, so we’ll go with 5) Suddenly after taking it for many years, my insurance changed their formulary and my copay went from about $6.00 to over $500.00 per month. My pdoc freaked out. I freaked out. Maurice freaked out. We searched every option, and my pdoc would send me home each month with boxes and boxes of free samples to keep me from going off of it.
Several months passed and fortunately my pdoc still had samples, but I was able to get Abilify shipped to me from Canada for around $60 bucks. Worth every penny, but a pretty big chunk of change when living on disability income.
I did the Canada thing for awhile, and eventually Abilify went back on the formulary and I was able to get it just down the street. My copay was back to around $6.00 again…until several months ago when my copay skyrocketed to $360/month. Things changed at the Canadian pharmacies again, so the best they could do was $330.00/month. Every month my pdoc would ask, “are you sure you can’t afford it?” He, obviously, has no clue what it’s like living off SSDI.
This time around, there were no free samples for my pdoc to give me so he switched me to Risperdal. That stuff was no good for me. While Abilify is known to be a weight gainer, Risperdal is that ten-fold. I didn’t have hallucinations, but I have had a series of pretty severe derealization.
Moving forward to this week. I got my usual prescription of Risperdal and I asked my pdoc to also give me an Abilify prescription so I can try to find some way to get it at a discount. He did and I started looking. I checked Abilify’s website to see if they had some kind of discount/free programs that I may qualify for. Lo and behold, they have a coupon that can be used monthly and pay only $5.00. There was a list of why you may not qualify. I can’t recall the reasons, but it said the only way to find out for sure is to ask your pharmacist. So off I went to CVS.
When I got to the counter, I asked the technician to check how much the generic would cost me, and if that didn’t work out, I could see if I qualified with the coupon. Well, guess what? I didn’t need the damn coupon because my insurance changed, once again, and my copay on Abilify is now only $1.20.
This should be good stuff, and it is, but it makes me concerned about all the hoops you have to jump through to get what should be basic medical care. If I wasn’t as level headed as I am this week, I would not have been able to handle it. If I wasn’t level headed, Maurice could have jumped through all the hoops and found out for me. But what about those without a family member, or loved one, to help them out? What about the people on the street? When I was homeless, there’s no way I could have dealt with this. As regular readers may recall, when I initially tried to get assistance from the Department of Mental Health, I was turned away because I was too high functioning. Yes, I dragged my duffle bag around town every day, trying to figure out where my next meal was coming from, but I was too high functioning. Assholes!
I’m ecstatic that, right now, my Abilify is waiting for me at the CVS just a block down the street. However, I’ll never forget the years I went through, walking in a daze, not knowing, but desperately wanting to, save myself. Our health system here in the U.S.A. has got to change. People are dying out there.
28 comments on Jumping Through Hoops
I’m glad your insurance is covering it now, but you are exactly right, it needs to change.
Hooray that you were able to get your Abilify! I’m sorry you had to jump through so many hoops.
It’s exhausting, Hart.
Glad you somehow got the abilify again!!!
Somehow, is right. It’s like waving a wand and seeing what appears
I feel ya. Been there and will probably be there again at some point I am sure. It is really horrible. People shouldn’t have to do this.
We shouldn’t, Iggy. Especially considering we’re most vulnerable when we need it most. The way the system works these days is sickening
I had the same problems with Abilify prices. A coupon from Good RX brought it down under $200 (from $800) at one point, which was the best I could do then. Now I get generic for $10 co-pay. But with changes to the ACA coming, who really knows?
OMG $800? That’s insane. Yeah, it’s wait and see right now regarding what’s going to happen to ACA. A lot of people are very scared.
I can’t get my RX…I make too much money on ssdi and my insurance is too good. I am on Medicare. .go figure! So I go without
I also make too much on SSDI, so Medi-Cal dumped me. Fortunately, my Medicare started paying the tab on most of my meds. Sorry it’s such a struggle for you.
if i could reblog i would. very on point. sadly true.
I know. It sucks that people can’t reblog from my site. I’m glad you stopped in though.
Good to hear from you again! I too was once homeless. (10 years). No idea what was wrong with me. Just walked past at least 20 homeless people in Cleveland The other day. My heart goes out to them because they may be like us and just need good medical care and TLC. My bipolar meds are working wonders for me but I’ve gained 25 lbs. and that part sucks. It’s a trade off.
It’s good to be back, Terry. My goals is to post at least a couple of times each week but I’m not doing well at that, so I post when I can. Yes, the weight gain part of the deal does suck, but I wouldn’t go back to the way I was for anything.
I’m so happy you were able to get your Abilify again. I don’t know what these insurance companies are thinking when they make such drastic changes. Apparently they aren’t thinking things through at all. I hope they keep the price way down for you from now on. It’s not right that they can play these games with our lives. It’s great to see you blogging again.
Hi Journey. The infuriating thing is that I get no notification. One month I’m paying $1.20 and the next it back over $300 without warning, which leaves me, Maurice and my pdoc scrambling for a solution. It’s no exaggeration that our current system is cruel.
Insurance coverage changes are maddening.
And my life is maddening enough…
Glad you got your meds back! Sounds like those were some crazy hoops!
They were and I’m glad too
I cringe when my psychiatrist adds a new medication because i don’t know if covered or not, and being on disability, like you said, every penny counts. Yet gotta find a way. Necessity is mother of invention. 🙂
Today I posted that I lucked out. Somehow my med is back on the formulary and I’m only paying $1.20 I don’t know why, but I don’t questions. 🙂
sometimes the planets align up just right 🙂