As transparent as I am about the state of my mental health, there’s been something I’ve been keeping from talking/writing about over the past few months that now feels good getting out into the open. For the second time in two years, my insurance company has wanted me to stop taking the main medication that’s played the primary role in keeping me from being depressed and very likely reduces my Anxiety. (A cocktail of other medications works with this anchor drug and lowers my Anxiety significantly more.)
Anyhow, my insurance company wanted me to transition to some other medication that is currently on their formulary to manage my Depression and Anxiety. No guarantees of success, mind you.
While Rebecca and I have fought this fight successfully before, this year’s threatened denial of coverage for my current medication seemed closer to definitive. (I include Rebecca because she’s really been more than an equal partner in this fight. While I became immobilized at the process of appealing to my insurance, Rebecca took this on as a challenge she — oops, I mean we — had to win.) This year we fought for my mental health to the point of an external review.
Just before I went on my vacation to Copenhagen we received a letter noting that we won the appeal (i.e. for at least the next 12 months insurance must cover my current anchor medication).
I share this blog entry for three reasons:
- I ask that if you must also go toe-to-toe with your insurance company to maintain your mental health, fight the fight if there’s a chance you can still win. Your health is too important.
- Keep a mental health journal. While I think that Rebecca’s argument — which included several parts — won the case, I was able to use Prone to Hope posts to describe how insurance physicians not demand I do something that could very likely put me in a place of considerably worse health.
- To thank my wife for being my constant support in achieving and maintaining my mental health throughout our relationship.
I am grateful to Rebecca for crafting the appeal letter that included this argument:
My appeal to physicians reviewing this appeal is perhaps cliche, but I will use it nonetheless: First, do no harm. I will be harmed by having to taper off a medication that is working well for me. I will be asked to go from a place of health and stability to a transition that will certainly bring me pain (actual physical pain) and suffering. I know this to be true because I have made these transitions before, when a medication stopped working for me and I had to transition to a new one. Furthermore, it is not known if the new medication will return me eventually to health and stability. The transition could require attempts at multiple medications and it cannot be known if a medication will be identified that can bring me back to the health and stability I am currently experiencing.
Maintaining my mental health (and winning) feels good.