In a world where mental health seems to be on the tip of every tongue, I have to say I was quite surprised to get a note indicating that my company’s insurance plan would no longer cover the “I function better without anxiety” medicine that I’ve been taking for nearly six years. Six years.
Say what, now?
Six years is a big number for me as my mental health brain is known as a bit of a code cracker (clearly that is not a medical term). What that means is that, in years past, I was forced into a mental health med switch every two(ish) years as my gifted-and-talented brain chemicals did an override on whatever meds I was taking at the time. We are a quandary, those with this gift. It became quite common, when my doctor would announce (upon prescribing the next big thing) “this can probably be a long-term option,” for us both pause for a moment, and then, oh, how we would laugh.
With my current meds (Trintellix), I reached and passed that two(ish) years mark four years ago. My brain is clearly either a huge fan or simply unable to crack the code. Whatever the case, it has made me a huge fan. And also my husband, my children, and everyone I interact with including the short-handed staff at the local UPS store.
So, yes, I was quite surprised to receive a note indicating that I would have to find a new medication option (from an included list). Surprised? Gut punched. This was not something I wanted to find in my mailbox. As an added bonus, this note arrived just two weeks before my current prescription was set to expire. I’m relatively sure that even those thinking of a career in psychiatry know that two weeks is not enough time for a successful medication switch.
Heck, the chances of gaining an appointment with my prescriber (or any prescriber at all) within that two-week window were laughable. Read the room, insurance friends: it’s been a rough few mental health years for the world. For a full medication switch, the typical path is a slow wean off the current meds in conjunction with a slow titrate of the new ones. “Slow” being the operative word and often equals months as the object is to not lose mental health ground.
The current lines to counselors or psychiatrists are very long. Two weeks? Hilarious.
As a second added bonus, the list of recommended alternative meds was verbatim to the list of all the meds I had previously taken. It was like a list of Cracked Codes Past. I know the entire document was likely spit out in bulk … but had the sender accessed my Caremark file?
I have had anxiety for much of my life. I can pinpoint moments as far back as fifth grade during which I felt an unexpected and unwelcome rise of panic. It was confusing and scary, but I have worked hard to meet it head-on. I have been vigilant with counseling and following all things prescribed including exercise (a mix of cardio, strength, and (sometimes) yoga), diet (including limiting caffeine, preservatives, and staying away from grapefruits), journaling (and turning it into a side-hustle), getting plenty of sleep, and yes, taking medications as directed.
I say this to make it clear that I’m not asking for a free mental health ride or a special pass or an exception because I’m not willing to take the challenge. I am not afraid to put in the work. I know that the work is an essential side dish to the meds.
I don’t have pandemic-related anxiety. I am not having a hard time adjusting to this new yet permanent work-from-home world. I am not plagued by the hormones of a fifty-something-year-old (though I am still plagued by hot flashes). This isn’t about an empty nest or a mid-life crisis or due to stress in my personal life.
I have had anxiety for much of my life. I have a very clear understanding of what works and what does not for me.
The note read that the meds that work will now be erased from my docket because my company has deemed them “too expensive.” This is terrifying, disheartening, and laughable. Our CEO is worth billions (with a “b”). Our company was just named “Nicest Place to Work” by Newsweek. We receive regular emails about work/life balance, using our EAP, and checking in with each other. We also receive regular emails about how ah-mazing we are doing. Best quarter ever! Record-breaking revenue! Nicest place to work!
This didn’t feel nice.
Three days after I received the letter, my request to refill my prescription was denied approval by my insurance. I had rushed to fill the remaining refill. Per our prescription plan, we are required to go with 90-day prescriptions (more cost-efficient) so I quickly hit the “submit” button to buy some time. My two-week window? Closed, evidently, before I even opened the envelope. I called our benefits department for help, as directed by the letter. The response? Yes, what a bummer…but I could always pay out of pocket or with a savings card. Yes. I could. I am lucky.
But what about all of our other employees who got the same letter and aren’t able to pay out of pocket? What if the lessened savings card cost of $500 per refill was still too expensive for those people? What about those who weren’t willing to dedicate a large slab of blood, sweat, and tears to fighting back?
Is this not an extremely dangerous game?
I won the battle. I made calls, I pleaded, I connected my physician with my insurance folks, I begged, and I scrambled, all while feeling the growing stress brought by several responses of “no” before I finally got a “yes.” Kind of. I got a one-year approval. This means I can either spend the next twelve months praying that this doesn’t happen again, test-driving several other medication options, or looking for a new job.
It’s not that I don’t want to be a good sport or a total team player. It’s just that I know that our company has been turning the cost-saving screws relentlessly for years now and it seems that the screws are now tight enough to begin pushing ah-mazing employees out the door. Good grief, we haven’t even re-opened most of our pre-pandemic offices (keep those costs down!). Our sales teams are still restricted from travel (keep those costs down!). For the traveler that lives in my house (and also works for the same company), that is a savings of several thousand dollars per month (you’re welcome). Sure, the isolation is slowly driving us all to a state of mental mush, but at least we’re being cost-efficient.
Nicest Place to Work? Sure.
I’m just not sure for whom.
In total fairness (or because I live in the world of fairies and unicorns), I’m sure our CEO has no idea this analysis of his employees’ pharmaceutical preferences has even happened. I’m sure there is just a constant vibe of “let’s save money!” and the team tasked with workplace benefits discovered this option. However, as we (employees) have ridden a two-year merry-go-round wondering at which point our name will land on the workforce reduction list, workplace stress is high. Anxiety is high. As CEO, he does not have to ride this merry-go-round of wondering if Friday will bring a pink slip. Perhaps he simply has no idea how it affects those who work so hard for his wallet.
Wait, do I have Stockholm Syndrome? Is there a medication for that? Can we afford it?