It's Time to Take Your Medicine, Away.

I’ve been off my meds for exactly 18 days.? This wasn’t by choice.? My hand was forced.

After years of being on various anti – depressants that didn’t work, I finally found one that did.? It was called Trintellix.

Turns out, it isn’t a generic drug, and it is expensive.

My doctor and I agreed that if it was working for me, I shouldn’t come off. As long as my employer would keep paying for it, he would advise it’s prescription.

21 Days ago, I called into have my prescription filled.?

Denied.

I was told by the pharmacist that I needed a new authorization letter from my doctor.

As I have technically switched employers, and health plan providers twice in the last 3 months, it was required, despite my doctor already approving this as a necessity within the last 6 months.

It is now Saturday, so I call the doctors office.? Obviously, it is closed. I send a message via my health chart.? URGENT.

“I understand it is the holidays, but my medication needs an approval.? Can you please expedite this request on Monday the 23rd as? I will be out of medication.? As well, I am leaving on vacation the 28th and will be out of the country for 8 days. I know it is not recommended to be off my medication.”

Monday comes around and by noon, nothing has happened.? I wait till Tuesday and call the office first thing in the morning.? Not only is the person rude, she fails to see any urgency in the matter.? After explaining a bit more desperately, she commits to getting the approval complete and sent to my provider.

Back to the pharmacy I go on the 24th.? My Prescription will cost me $1200 for a 3-month supply.?

Can you please re-run that. It has been approved as necessary by my doctor.?

Under my previous insurance and provider, the cost would have been around $90 before using my drug specific savings card.

Keep in mind that I had to fight to have this medicine covered almost every month under my previous provider. I would get a letter monthly saying, I could save XXX amount of dollars per month, if I would switch to a generic. What they meant to say is, your employer will save XXXXX amount.

No.? This drug is prescribed by my doctor, it is working. I do not want to change medicines. This is the best version of me.

It is obvious, that employers and insurers do not want to cover these costs if there are alternatives that will work. However, I had done my due diligence, went through the approval process and developed a care plan specific to my needs with my doctors.? I also paid for my insurance every month.

“I am sorry sir, says the pharmacist, this is what your prescription will cost under your current insurance.”

After calling my provider, and having panicked discussions with them on Christmas Eve, I learned that I made a mistake.?

Despite previously being on a High Deductible Health Plan, and Continuing on a similar plan with my new employer, I missed one very important detail.

My previous HDHP was for medical care only, the new one combined the Medical care and Prescription Costs.? OOOPS.

This means that before any of the cost of my medication would be covered, I would need to spend $5000 in medical and RX bills before my co-insurance would kick in.?

I had been on my medicine for so long, and it was relatively in-expensive on a monthly basis – I didn’t even think twice about signing up for this plan.?

My decision was to cold turkey go off the drug, instead of paying $5000 out of pocket for it.? This was well thought out, although not made without fear.? I decided to attack this decision like all others I make in my life, with vigor.

I decided to quit drinking alcohol.?

I decided to make my health, my number one focus, including diet, exercise, and mental clarity.?

I decided to focus on the things most important to me in my life.? My family, my purpose, and my personal growth.?Everything else is being pushed away.

That is what I can control – and so far I feel great.? Scared, but great.

I share this story for several reasons.

Primarily, I think our health care system is broken.? Through this entire 8 day process, I wasn’t treated very kindly, and no one really seemed to care.? I find that to be sad.

Secondly, this is my profession, and why I am passionate about being a leader within it.? Despite all my knowledge, I made a mistake and can’t fix it.? I worry about individuals that are completely overwhelmed with their medical decisions, their cost, and how to best take care of themselves and their families….My job is to fight for them to make sure that every single employee I represent makes the best decision they can make for themselves and their families.

Lastly, I share it because I have a voice, and I need to trust in it more.? You will hear more from me in 2025.

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