Lamictal Disaster - Bipolar Disorder Message Board

Theava · 10-23-2007, 04:31 PM

I dont even know if this is going to make sense to anyone but here we go...

So this all starts a few months back...

I started taking the lamictal starter kit and everything went well.
I got up to a 100mg and then to 200mg and then to 400mg.

Here is the disaster part:

I went to go fill my script a little while ago and the insurance company denied to cover it. They wanted me to mail order it, but I hadn't received the script to mail them. So the pharmacist called my doctor and got me a slightly changed script in to get around the policy. So in the meantime I keep waiting for the script to come and it doesn't. I get my doctor to call in the script again (to her dismay) and I go to pick up a starter kit from her (which will last me like three days). But the insurance still wont cover it. I haven't got the script in the mail (i guess it is lost), and I can't call my doctor because she probably thinks I am trying to extort lamictal out of her or something.

So I am here 3 days after my last dose (400mg/day to nothing in one day) and I am freaking out, with nothing to do. I have no idea what I can do, the insurance company wont pay for the refills at the pharmacy and I cant do anything to get them. Is there anyway to recitify this? Im losing it...

seaturtle · 10-23-2007, 05:56 PM

Ouch, ouch. I had to go without Lamictal for a couple of days, and I remember how I felt. You must be feeling godawful.

I think you should persist with your doctor until you get that mail Rx. Can you go to his/her office and ask for it in person? I have done that. I don't understand why your insurance all of a sudden will not cover it. Have you called your insurance company and demanded to know why? Did the pharmacist contact the insurance company and speak with them? If not, he should - mine does that.
It takes some aggression to deal with this junk.

Well, a couple of other suggestions. If I were in your shoes (and I have been) I would call your governor's hotline, call the state's Health Care Ombudsman (they have been extremely helpful to me), call Psychiatric Survivors if there's a branch in your state - and even if there isn't.

Do you have a therapist or social worker? If you do, it is their job to help you out here, make calls for you.

I am sorry your doctor is that way. He should know that going without Lamictal all of a sudden like that is dangerous; it's a drug you have to taper.

I would go as far as contacting my legislators (I have done that, too) and explaining the situation and asking for their help.

Can you do these things, or do you need an advocate to help you out. If you do, I would also contact ****. In fact, contact them anyway.

I know all this seems like an overwhelming amount of work, but it might yield results.

Last thing - some drug companies will supply you with free drugs if you cannot afford them and don't have the insurance coverage, so a call to the manufacturer is worth a shot, too.

I'm sorry if this seems like too much information, but I'm trying to pull out all I know, hoping that you can get some help. You really need that medication.

Anything I can to help, I will do it, and please let us know how things are going. And I can't see your doctor thinking you are just trying to get Lamictal out of her. It is definitely not that kind of medication.

Hope to hear from you, hang in there...but don't be afraid to act on your own behalf.

Seaturtle

Forgotten1 · 10-24-2007, 05:29 AM

This is bad. Seaturtle is on the right track. You should go that route. I know in certain states if you have a low enough income you can qualify for a States secondary insurance. In California isn't called MediCal. It won't be quick enough for you, BUT, as in the case with MediCal you can pay out of pocket and they will cover the med retroactive up to 3 months. What you have to do with MediCal is go, qualify based on income usually, and rush the process by stating MEDICAL NECESSITY. On the forms mental illness is clearly listed. And then the process starts and can take up to a month. BUT if you go to EPS (or the like where you are) Emergency Psychiatric Services (which is part of the county health system) and they are required to help with temporary meds if it proves necssarry. They will diagnose and you will get help. I know. I've done it myself for others, and had it done for others who probably would let me do it

-- like my friend. And you can get the Lamictal through them. They will want to know your income level and they will bill you if you don't get the state supplemental insurance (like MediCal). BUT, as I said in the case of MediCal ONCE you are approved, you can get paid back retroactive up to 3 months, you just prove you are going through the process when you are treated. NOW...IF you are denied, in the case of MediCal and the county system in a state like California, THEN you go and SHOW them the denial letter. And in that case they usually waive existing balance/fees and you continue from that point at a reduced cost, based on income, but it will be out of pocket.

In any case I advise contacting the county health system in your area, explaining your situation asap and going that route. Then get supplemental insurance through your state or county, IF they offer it.

If all this seems daunting then contact **** (just do a search on "****" in your state and area (they ARE nation wide). Print off what I have said, read it to them and ask them if you have anything similar in your area. I'm SURE they know and can advise a emergency solution. They are there for exactly this and more. I'd be surprised, if you live in a metro area if they didn't have a EPS (Emergency Psychiatric Services) of some sort for you to go to. Just know that it is usually a lock down facility and they can hold you for 24-72 hours IF you are a danger to yourself or others.

Please let us know how it goes.

Tinkerbell79 · 10-24-2007, 05:59 AM

Theava,
I have been in your shoes just last week. I can totally sympathize with you. Please excues my typing I made a huge mistake last night and stayed up ALL night talking to a guy from 12am-5am that I've been talking to on and off for a while. Anyway I was in a manic mode and didn't miss the sleep till about an hour ago my body is slipping lol.

Anyway back to the subject at hand. I'm kind of lost but I know when my ex used to get mail order scripts the Dr had to fax over the script and then everytime you needed a refill you call the mail order place and refill it till you have no refills left. My question or maybe I'm confused and not reading right due to being tired. But why would they be mailng the script when we are not in the days with no technology. The should have FAXED that script over. But yes I definatly agree with seaturtle. I don't have as much experience as she so i would listen to her adivce.

I know it is a lot of hard work and when your down about something it makes it harder. I'll tell you by last week being out of my meds I finally got to the point of my depression taht I was severly agitated by EVERYTHING. I think that helped cause I spoke up more than i would have before. I'm not telling you tobe mean just be assertive. Demand what you deserve and expect nothing less. I cant beleive how some pple can tinker with ppl's meds and illnesses. it's totally unethical. A nurse at an urgent care center I called actually had the nerve to tell me that I could wait 2 weeks to see my new pdoc and not worry about missing those 2 weeks of Lamictal!!! Like heck..I know how I am when I miss ONE dose.

But sorry to ramble. Seaturtle and I'm sure a few others can point you in the right direction. I say this over and over and since your new here everyone on here is awesome and in some way can help you with advice or kind words or point you in the right direction when you need help. Keep us posted and let us know how it goes. Good Luck on getting your meds.
(((((hugs)))))
~~~Tiffany~~~

tony72 · 10-24-2007, 07:32 AM

Theava,

I am sure that the PDr. won't think that your trying to extort Lamictal from him/her. Really it is in his/her best interest to help you work it out.

They get these samples from free from the RX reps and he must have a drawer full. I would go back and insist that you talk to the Pdr.
Explain that you can get it, but that it has to be via mail rx. Estimate the time that it will take you to recieve the order and ask for that much in Samples. If he won't give you that much - then ask for 1/2 in samples and 1/2 in a script to the pharmacy= something you can afford. My 300 days supply was 258.00 from Medicap and I'm sure it is cheaper from Walmart.

Even if you have to pay for the first month stay on the med. It will all work out. Please don't panic - I know I would be panicing and I was feeling the same way about another script last week that wasn't covered.

Let us know how it works out.... (((hug)))) T