Medication Refill Denied

Just spent one hour at my local pharmacy.  I had requested via the usual automated telephone system a 30-day refill of my anti-depressant and anxiety medication.  The pharmacist informs me that my insurance has declined to refill my script because this medication must only be filled through a “mail-order” pharmacy.  It’s a Sunday and the local insurance help center is not open.  The pharmacist spoke to someone in the national help center, which has very strict protocols about helping or not.  So no override available so that the pharmacist could not officially give me a few days of my medication.

I have been using this medication for about 8 years and getting a 30-day bottle with this same pharmacy the whole time.  The national insurance help center says they mailed me notification about this change in October 2014.  I have received no such notification.  And meanwhile, the prescription has been successfully refilled every month.  I don’t understand why this didn’t trigger a “red flag” at the insurance company and a repeat notification sent to me or an email or some contact.

I am very sensitive to pharmaceutical medications.  It took me 3 years to get to the correct-for-me dosage of this medication versus the pharmaceutical company’s recommended schedule of 6 to 8 weeks.  For me at this dosage, I am incapacitated unable to drive, unable to see clearly and clear cognitive thought is not possible if the once-daily dose is missed even by a few hours.  I made the mistake once a few years ago while traveling out-of-state.  It took me most of 3 days, confined to bed, to recover from that delayed dose.

So out of the pharmacist’s compassion and understanding for me, he gave me 2 days worth and told me precisely what I need to say to the local insurance help center, on Monday morning, to insure that I get my medication for this month while the mail-order prescription service is being setup.

This event was emotionally disturbing to me.  One that my healthcare is taken for granted, again, by anonymous others.  Two that this happened in public, not over the phone while home, so I felt really exposed and unable to protect myself.  Anger and frustration that this weekend’s (Sunday & Monday – because I work on Saturday) rest seems to no longer be feasible because can envision spending lots of time on the telephone tomorrow getting a resolution.

I immediately texted my brother as I could feel the emotional overwhelm ‘swamp’ me.   I successfully walked to my car and was able to sit in the car while my brother and I exchanged texts.  I observed as Becky dissociated (or was gently moved away from front stage*).  The Kids’ stone face moved to front stage and figured out what and how immediate plans needed to change.

Becky had planned on completing two other errands and then having a late lunch or early dinner out on a gift card.  One of the errands was no longer possible because the store had closed while she was talking to the pharmacist.  The Kids determined that other errands were no longer feasible, as the strength for engaging these tasks in ‘public’ was gone.  The Kids decided that we needed to do our due diligence of finding and printing the forms for the mail-order program, so we would sound and be relatively prepared for the conversations tomorrow with the insurance company help center and requesting the immediate required prescription from Becky’s physician.

*=see Page called Internal Organization and Parts