My medication mix up and an eye opening experience about the cost of care for my diagnosis
$522 dollars. I stared at the price displayed on the front of ONE of my regular medication bags with a month supply as the pharmacist called my insurance company to verify I had an account. The start of a new year meant that they needed to confirm insurance and this was now my second attempt at picking up my prescriptions. Luckily I’m normally about 3 weeks ahead on refills, so I wasn’t panicked. I don’t carry around a purse very often, so as soon as he told me I would need my insurance card I let him know I’d be back in a day or so when I had time.
That day or so was now. I brought my insurance card back, but when they typed my information into their system it kept giving them an error message. They called the company to see if we could rectify it over the phone, but no such luck. Blue Cross had me in their system, but whatever member information they were sharing from my account wasn’t satisfying the pharmacy system.
I told the pharmacist that it was no big deal. I’d call the company or have my employer reach out to figure out what’s going on. At the very least I could have my doctor submit a prescription to another pharmacy and make an attempt to pick it up that way. As a new patient is entered into a system for the first time. But as I made my way to the front of the store and out into the cold, it wasn’t just the shocking temperatures of the air that took my breath away. It was the thought that I could be paying up to $800 a month for my medication that I so desperately need to manage my bipolar disorder and remain balanced. That’s essentially a second rent!
When I was first hospitalized and given my diagnosis, the doctor told me that I would be starting to take some medication to help me sleep and regulate the chemical balance in my brain. “Two pills every day. For now, you take one at night which will make you feel pretty sleepy, maybe loopy even, and then another pill you take in the morning or night. You shouldn’t feel anything from that one.”
He explained that my medications were classified as psychotropic which sounds much scarier than it is. It essentially just means that they’re medication that helps my brain specifically. I’m not going to list my medications. You can read on and learn the why behind that below. But by getting more sleep my brain can rest and restore. Being able to put me to sleep, especially when I am hypo-manic or ramping up, is a great power move on me. And in balancing the extremes in my mood I’m less likely to cycle up to an extremely high level of mania or low into a deep depressive state.
For me, there was no sense of shame. Or the question of when I would be able to stop taking the pills. I don’t mind the idea of taking daily medication for the rest of my life. To be honest it gives me a sense of control. But there are other things at play. For bipolar specifically, there are 12+ medications that a patient may take, typically a minimum of 2 - but a wide variety of possible combinations. That often makes it hard to find the right medication and combination which can lead to weeks, months, or even years of ups and downs accompanied by some pretty extreme side effects.
For me, I didn’t have any life-altering side effects from my medication. I was very drowsy and had a hard time waking up in the morning for the first 2 months or so. I gained some weight, but not 60 pounds in 6 months or anything. More like 15 pounds in 3 that just stayed on after that. I was lucky that my doctor selected a medication cocktail that I responded to pretty quickly, and have been on ever since. Sure, a day will probably come where my body is adjusted to those medications and we need to revisit the plan, but for now, I’m happy to have medications that make me feel empowered and I’m proud to take them every day without fail. I have a weekly pill jar and I use it religiously. When I first bought it I felt like a bit of a granny, but 2 years later it’s one of my favorite things. It keeps me sane, both metaphorically and literally.
Now, all of that was in jeopardy. I was terrified as I thought about what kind of impact spending $800 per month would have on my life. Not getting the medication was out of the question. It’s a medication that I need. Having great insurance through my job put me in a place the past 2 years where I didn’t even understand or think about the cost of my treatment, care and medication. Not being able to process my insurance in the new year not only created a short term problem - what am I going to do about medication if we don’t get this resolved in the next 6 days, but it also highlighted a lifelong problem that I’ll have to battle internally, and subconsciously, forever. Do I have a job with insurance that can support my life, health, and diagnosis?
I’m reading Obama’s most recent memoir right now - A Promised Land, and this past weekend I read his 2 chapters focused specifically on his healthcare bill and initiatives while in office. Don’t get me wrong, that program wasn’t perfect, but I do have a new appreciation for how important access to affordable healthcare is. I also understand how crappy the concept of pre-existing conditions is. Now that I’m labeled with a diagnosis, and an insurance company can anticipate the coverage and care I’ll require, they can turn me away or charge me an exorbitant amount if I’m not protected through an employer as just another number? That doesn't seem fair. And it goes beyond medication, right?
When I was hospitalized and treated in intensive therapy for the next 8-10 weeks I wasn’t racking up insane medical bills for myself, because I have good coverage. I saw people get discharged or turned away from care because their insurance coverage for inpatient treatment was up, or they couldn’t afford to take the time off work to even be there and get the treatment they needed. And this happens in non-mental health-related situations as well, right? I’m sure you know someone or a friend of a friend who has been crippled by hospital bills. Maybe their loved one already died of cancer, but they’re still here making monthly payments of hundreds of dollars to pay off the coverage that they never could have afforded. Even if their loved one had lived.
I’ll conclude this piece on a bit of a high note, and a few key points to take away in the name of the topic of medication. I was able to finally pick up my prescriptions yesterday and pay under $20 for my monthly supply. I’m extremely grateful for that. But I’m still troubled by how expensive they would have been otherwise and want to learn more about medication accessibility for those who don’t have good coverage.
Lastly, on the topic of medication, there are a few rules/thoughts/perspectives that I want to share from my own experience.
1 - Never talk to other people with a mental health diagnosis about which specific medications you’re taking. Names and doses don’t matter unless they’re a medical professional making a medication decision for your treatment plan. This is something I learned very early on in treatment and it’s important. You’re not going to gain much valuable insight from someone who isn’t qualified on the topic of medication and dosage. For one - each and every person is different. The factors that go into their experience with their diagnosis and the medication needed to treat that is not the same as recommending a friend take ibuprofen for a headache.
2 - If you’ve been prescribed medication and you’re struggling with it, talk to your doctor. Don’t just stop taking it! The more and more I read about bipolar disorder and mental health in general, the more I hear about patients not wanting to take their medication. Whether they’re starting to feel good and don’t think they need it anymore, or they feel stigmatized for taking medication in the first place and want to be off of it as some sort of accomplishment, both instances are no bueno. Feeling good and thinking you don’t need medication anymore is so common. But have you ever thought that maybe you’re feeling so good BECAUSE of the medication? I know it’s a tough shift mentally, especially if you feel that taking pills is a bad thing. My pills empower me. Try taking that approach one day at a time and see how you feel. “I take my pills to balance myself and make myself feel better.” You can choose to take them and be empowered by that!
3 - If you have people in your support system who have strong opinions about or against medication, and your doctor has also told you that you need medication, set a boundary with that person in your support system. You need to give medication a shot, and if simply not telling your support system that you’re taking medication is the solution, then do that! You are the top priority and the opinion of your doctor is far more important for your well being than the negativity of someone who is against medication.
