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Wednesday, October 24, 2012

Unmedicated Mama: An Inconvenient Truth

The insurance company is up to its old tricks again. They are refusing to allow the refill of my medication because they feel that I don't need it. How did they get this opinion, exactly? Well, I conducted an experiment this summer to determine how well I could function without the medicine. I wanted to see if I could manage my attention challenges through discipline and diet, because let’s face it—filling that stupid prescription is pretty darn inconvenient. Since I missed a month of requesting a refill, they've concluded that the medication is unnecessary.
Obtaining the medicine is an intricate and lengthy process, and I contend that a person would only set out on this quest if the medicine was absolutely necessary.

Because of the nature of the medicine, there are never any refills available by dialing the pharmacy number. You have to physically obtain a paper prescription every time, and you have a very tiny window of time to accomplish this, because they are only allowed to issue the RX every thirty days. This means that you have to be very aware of when you’re running out, so that you can call the doctor and get a new script. I have yet to master this awareness. I usually realize I’ve run out as I’m placing the last tab in my mouth. This is a VERY big problem, because once I’ve run out, it’s incredibly challenging attention-wise to a.) remember to call the doctor, b) remember to pick up the script, and c) remember to get it filled.

YES. Leaving a message on the nurses’ line is challenging.

You have reached the nurses line at Dr. [Amazing]. If you are calling about a prescription refill, please leave your full name, date of birth, medicine and dosage, and a phone number where you can be reached. Have a good day!


Um, Hi Dr. [Amazing]. This is me. I’m out of medicine, so I need to request a refill. Okay, so… [Full name]… My birthday is April 18... Wait, should I say it in numbers? Four-eighteen-seventy-nine. That’s 1979. Sorry, of course you knew that’s what I meant. My phone number is [phone number] and the dosage is… [dosage] Wait, let me look at the bottle just to be sure. Yup, that’s what it was. Did I already say my phone number? It’s [phone number]. I’m so sorry for this rambling message. I ran out of the medicine two days ago. Or was it three? I’m so sorry. Thank you, Dr. [Amazing.] I’m so sorry. Have a good day!

As a consummate problem-solver, I’ve started to write down all the info on a post-it note before calling. Smart, right? Then why do I feel so stupid when Russ finds the sticky notes and asks why I’ve written down my name, birthday, and telephone number?

Once that step is out of the way, it’s time to go pick up the slip. My doctor is in North Dallas, and it takes about 25 minutes to get to her office. This alone is not a deal breaker. After all, the doctor lives in our area and commutes to her own office six days a week, while I only have to make the trek once a month. The trip down and then over to the pharmacy takes about an hour, sometimes more since by now it is now usually afternoon/evening rush hour.

At the pharmacy, it’s very difficult to wait for the prescription to be filled, because
1. It always takes much longer than they say it will, and
2. When you have a bunch of kids needing dinner and homework help, that trumps just about everything else.

So I drop it off with the plan of coming back to pick it up later in the evening. 
As if.

When I was working, there was a time gap between when I was required to be at work (8) and when the pharmacy opened (8:30). If I was already unmedicated, lunchtime and copious amounts of time after school were spent either inventing fabulous new ideas or obsessing over details and making very thorough lists to make sure I didn’t forget about anything important.

Sometimes it was a few days before I could pick it up.
Sometimes the pharmacy had to call me to remind me to pick it up.
That was sort of embarrassing.

That was our normal once-per-month best-case scenario procedure. It was even more complicated when there was a medicine shortage last year; we had to drive all over town trying to find a pharmacy that had the medicine in stock. (We eventually found one—a tiny, in-hospital one on the other side of town that was only open Monday through Thursday, 9am to 5pm.)

I wish I could put the insurance company in my pocket and take them on my monthly adventure before they go deciding what I do and do not need.

This is not the first time they’ve tried to interfere. When our employers first switched to their company, they refused to allow the prescription to be filled at a local pharmacy. They tried to force us into the mail-order program.

THAT was a rough phone call, too.

Representative: The company would prefer that you use the mail order program. You’ll like it. It’s easy and convenient, and it will save you money.

Me: How does it work?

Representative: Your doctor faxes us your prescription, you pay online, and we ship 90 days of your prescription right to your door.

Me: Wow, that does sound nice—right now, I have to go down to pick up the paper prescription of the Adderall—

Representative: Oh, Adderall? No, that one can’t be faxed. You’ll need to mail us the paper prescription. But once you do that, it will be easy and convenient.

Me: So I still need to drive down and pick it up, and now I have to mail it to you, which means addresses and stamps and envelopes and the post office—

Representative: You’ll also need to make sure that we receive it within five days of when it was issued.

Me: --and then you just... mail the medicine to me?

Representative: Right. They deliver it right to your home.

Me: Well, I guess if it would save two extra trips to the doctor...

Representative: Oh, your medicine doesn’t qualify for the 90 days. It would be 30. But it’s easy, and it’s convenient.

Me: Do they just put it in your mailbox? That doesn’t seem very safe.

Representative: No, you have to sign for it.

Me: What if I’m not here?

Representative: They take it to the distribution center in Richardson. There’s an afterhours pickup window for your convenience.

Me: This doesn’t sound very convenient at all. I don’t think I want to do this plan.

Representative: If you choose not to, your prescription cost could increase dramatically.

Me: I guess I’ll have to take my chances.

Shortly thereafter, I checked in to the cost of the medicine without insurance.
Three hundred some-odd dollars. Per month.

Wouldn’t YOU want to experiment with survival-sans-medicine?

Ultimately, my experiment was a colossal failure. I’m an utter disaster without the medicine.
So is the house (which often looked like a laundry piƱata exploded.)
So is the bank account (because our home's inner-peace did not improve when I expanded our Buddha sculpture collection. Or ordered that ukelele, for that matter.)

And the truth is, I don’t mind the inconvenience of getting the medicine, because the benefits of my unmedicated creative spontaneity (like the recycled water bottle greenhouse project) don’t really outweigh the daily responsibilities (like preparing dinner).

So really, we’re all better off if I just stick to the medicine.
Now could somebody PLEASE convince the insurance company?

1 comment:

  1. What? I loved the water bottle greenhouse project idea!