I am motivated this morning to make this my very first blog post. Every month I try to figure out where the insurance company gets their basis that, when you turn 18 years old, your condition just magically disappears. I say every month because that is how often I fill the prescription I need to control my symptoms. I am 40 years old and I spin ’round and ’round like a second grader during story-time. A child of that age, about 7, would be taking the exact same medication that I am on. Difference is, that his state-paid insurance wouldn’t even ask for a co-pay before filling his Ritalin or Adderall; mine, on the other hand, requires a PA or Prior Authorization, which is an official diagnosis of a disorder requiring the use of stimulant medication to treat, eg., ADHD. And a PA isn’t an immediate clearance for the prescription fill. It can take days for the pharmacy and the doctor to get the proper validations signed and submitted to the insurance company. Or, in my case, possibly, months! But, when all the ducks are in a row, and the proper paperwork has reached the proper person (whomever that is), your golden ticket will be redeemed; aaah! Finally, the spinning will stop, the fog in your brain will lift, and you can finally look your husband in the eye and comprehend the blah, blah, blah, that’s been coming out of his mouth.
But, as in my case, it may take months to get my medication filled. I took my script to the pharmacy, explained that my insurance probably wouldn’t cover the medication (Vyvanse 30mg). Yesterday was the only day my Dr. was going to be in the office, he wouldn’t be available again until April. “Please make sure you get the PA request to him by 5pm”. I was assured by the pharmacy that it would be faxed within an hour. Well, needless to say, it didn’t get faxed until late yesterday. The PA cannot get done now until April. So, now what do I do, the medication is almost $300 for one month, can’t afford that. I looked up the drug manufacturer on line, Shire, sometimes they will offer discounts on their medications. the only thing they can do for Vyvanse is a $60 off coupon. Still too expensive!
So, at this point, I am assuming that I will be out of medication for at least the next month or two. Not a huge deal, I’ve went un-medicated before, so shall I again. Frustrating though, that my insurance will cover any other medication except my stimulant ADD medication. I wonder why that is? For anyone diagnosed with childhood ADHD, all scripts will be filled, no problem. Like I said before, I’m 40 years old, spinning like a top, and living proof that ADD does not go away!