Do insurance companies suddenly cut you off of anti-depressants and other psych medications?

[progree]

Last edited Wed Dec 28, 2016, 12:21 AM - Edit history (2)

I have a friend who is reluctant to even try an anti-depressant because she might suddenly be told, "sorry, no more refills".

I thought it was extremely important to taper off most psychoactive medications, instead of stopping all of a sudden. And that even as assholic the insurance companies are, they wouldn't do this. Or am I naive to think they have even an ounce (or gram) of humanity?

Thankx

Edited to add - she's insured through Minnesota's Medicaid program, administered (and whatever else), in her case by Medica.

[TexasTowelie]

1. It has happened to me

not only with anti-depressants but with neuropathic medications like Lyrica also. I try to refill those prescriptions about a week before they run out in case I have to jump through hoops to obtain the medications.

[progree]

4. But no problem with the insurance company setting some limit? BTW she's Medicaid-insured

She can't afford to pay the full or even half the cost out of pocket.

[TexasTowelie]

5. There is also the issue where doctors prescribe the more expensive medications

than are only marginally more effective than cheaper generics. That is true for both anti-depressants and neuropathic medications. I noticed that whenever my doctor would switch me to this new "great" medication that within six months there would be a major advertising campaign promoting those medications on TV.

In the case of Lyrica, a 100 pill bottle runs over $315 (that was when in 2014 when I last took it) compared to gabapentin that runs about $20 for a 60 pill prescription. In addition, Lyrica is a Schedule V controlled substance and I had to come in at least every six months to the doctor to have my prescription renewed so my doctor had a financial incentive to prescribe that medication.

[progree]

8. Thanks! nm

[elleng]

2. Companies/corporations have no 'humanity.'

Physicians/prescribers MAY.

[progree]

3. Yes, but she's worried about the insurance company not paying anything on the claim

i.e. covering somebody for only 3 months or a year or something like that.

She doesn't have the money to pay the full cost out of pocket.

I don't worry about a physician / prescriber suddenly cutting off somebody from a medication that is dangerous to go cold turkey on.

She's on Medicaid.

[No Vested Interest]

6. She should speak to the prescriber - presumably a physician- about her concerns,

especially if she has already been prescribed the meds.

They sometimes have sample of the meds to give patients, although most pysch meds are considered controlled substances and perhaps cannot be just given out arbitrarily, even by doctors.

She could also speak with the pharmacist delivering the meds, asking to be informed in advance of any coming changes in availability for herself.

[progree]

7. Thanks! nm

[Crunchy Frog]

9. They're not considered controlled substances, with a few exceptions,

benzos and Adderall, for example. Regular antidepressants, and even antipsychotics, can be purchased from online pharmacies without a prescription. I've gotten lots of antidepressants as samples.

[No Vested Interest]

10. Thank you. Perhaps in some jurisdictions (someUS states) they are considered controlled substances.

I'm aware that by purchasing some items online one can get around the prescription requirement, as I was looking to purchase online a piece of medical equipment that normally requires a prescription and saw that at least one provider had a simple means to accomplish that.

[mopinko]

11. it could happen, but i think it is unlikely. a lot of pharmacists

will advance you a few pills if your script is interrupted, so that you wont go through withdrawal.

my daughter is still on her dad's policy, but also medicaid eligible, so they pay her co-pays. i am also on that plan. we take a few of the same meds, but she takes way more than i do. she is young, and also very complex mess. she has a lot of docs, takes a fair amount of pain shit, and we are sure they have her tagged as a drug seeker.
the insurance co occasionally holds up a refill for her, and it is a couple days of hell. they have never done this to me.

however, they have never flat out just cut her off a drug.
short of losing her insurance altogether, that really shouldnt happen.

and of course, if she should find herself in that situation, she should report to the er. they could treat her withdrawal symptoms.

[progree]

12. Thanks!