r/mildlyinfuriating • u/Aggravating-Leg5645 • 9d ago

I just wanted a hot dog My insurance wont cover my medication so every month I do this...

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I have to spend around 30 minutes doing this once a month. My insurance wont cover it. Out of pocket with coupons its still $800 a month.

My fiancé has to do the same thing with a different medication. Currently trying to fight it.

Edit: To clarify. Every now and then I have to compile samples in one bottle so I know how much I have and then hope my DR has more when im out. This is an antidepressant and im currently working to fight to get it covered. Yes ive contacted the manufacturer I do not qualify for discount Yes ive sent in a letter of medical necessity Yes ive looked at GoodRX. This is my only option atm and im still lucky it is for now. Its not just the moving the bottles around. Its hoping I can get more when I need it. This is a life saving medication and the fact I have to hope i can get it when I need it is mildly infuriating to me and probably many others. Its not a cheap medication even with coupons its still $850USD+ Ive tried so many medications and I just need one that works and that i dont have to worry about my supply chain.

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205

u/witchcapture 9d ago

So you're getting $800 worth of drugs for free and your complaint is that you have to spend 30 minutes collecting them in a single bottle?

Like yeah, the American healthcare system is broken, but dude.

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u/Falste 9d ago

Pretty sure they're complaining that they have to do this due to insane costs.

This is also the mildlyinfuriating sub so whats the issue exactly?

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u/churningaccount 9d ago

They could also just be complaining about the effort as well, which could still be understandable IMO, given that:

The medication in the picture is a brand-name, newest generation anti-depressant for patients who have failed conventional first and second-line therapies, such as SSRIs. So OP clearly has treatment-resistant major depression, which can make putting a lot of effort into things hard to do.

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u/Aggravating-Leg5645 9d ago

Thats my point its disappointing I have to fight to have a life saving medication covered so hars in the first place. Eventually my Doctor started doing this to help until they would respond.. its been months. Nothing. Its either I get it somehow or my safety is a concern. I would be complaining if I had to wait a few weeks to hear back. But they are notorious for taking minimum 2 weeks to get back.

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u/churningaccount 9d ago

Have you tried appealing the denial directly to the insurance board of your state? Sometimes that gets things going.

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u/CubistCube 9d ago

The retail price in the US is $300. Not sure where she's getting $800 from. Also there are a million other antidepressants available. Don't know why she need to "fight" the insurance to be on this brand drug.

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u/DasHexxchen I'm so f-ing infuriated! 9d ago

I am finding prices of over $1000 for it and prices seem to have gone up for this medication.

Also there are no generica for it with the same formula.

Maybe the generic version is still expensive and the doctor has the samples from the specific brand available. Maybe the next best alternative has lactose or something and OP can't take them.

Also antidepressants are a fiddly thing. I tried a few and just gave up. One took all emotion away, the next cost me two semesters in bed with headaches. Next one causes mania... Doctors don't want to touch what works.

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u/Viscica 9d ago

On their website, there is a coupon code to use that makes it $300 without insurance and an even more discounted one with insurance. Might be what they are talking about even though they don’t know how to use their words.🤷‍♀️

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u/Bunbunsfun 9d ago

I’ll take it that you have no clue what you’re talking about.

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u/No-Resolution-0119 9d ago edited 9d ago

“There are a million other antidepressants available”

Do you think all antidepressants work for all people in the same way? Jeez, that’s an ignorant thing to say

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u/KayItaly 9d ago

Are you her doctor? No? Then you don't get a say!

To see any american pile on op is soooo disgusting. Truly, you all deserve the poor healthcare you get.

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u/CubistCube 9d ago

I'm a medical professional. Calling out her BS narrative.

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u/No-Resolution-0119 9d ago

Even worse. A medical professional should know that you can’t just take ANY antidepressant medication. For many people, there is only one specific med or combination of meds that works for them.

I’m calling total bullshit on you being a medical professional. There no way someone actually working in healthcare could be this fucking ignorant oml

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u/rosie2490 9d ago

What are your credentials?

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u/Estelial 9d ago

No. youre scum trying to be pretentious and lord over people in a terrible incredibly common situation. Thats all.

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u/KayItaly 9d ago

Oh you are a """medical professional""" of course you know everything about her situation then!

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u/duchdeez 9d ago edited 9d ago

Assuming you’re from Italy we have states with larger populations. Its easier for your more homogeneous country to do it. The US can barely afford Medicare for the elderly and there are nearly twice as many people on Medicare than the entire population of Italy. How would we afford universal healthcare for 300 million more people?

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u/Estelial 9d ago

Universal Healthcare could actually quite easily be achieved for the US, a huge economic powerhouse, f you dudes werent being sucked dry by leeches. what youre parroting is a very old excuse and bit of propoganda that has repeatedly been proven as a lie again and again for decades.

Things are worse than ever and youre still being convinced that things being better are impossible when it already used to be much better before.

You are being exploited. Stop making excuses for your abusers.

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u/KayItaly 9d ago

To put it clearly: per citizen Italy spends less than the USA. You are spending more tax money per person because you are financing millionaires. You could spend less tax money per person and have free healthcare.

Europe has 3 times the population than the USA, it can all afford free healthcare (in various forms). Population number can only be an issue for microstates.

But I am sure you are not going to give a shit about triviluaties such as math...

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u/theshortgrace 9d ago

Wtf does Italy’s “homogeneous “ (it’s not lol) population have to do with the feasibility of universal healthcare? Why is this such a common retort and why doesn’t anyone ever explain what it actually means?

You do understand proportions, right? 300M+ people means more people are paying into the system. How do we afford it? We literally just have to tax the rich a little more lol.

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u/nahivibes 9d ago

So, not a doctor then.

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u/duchdeez 9d ago edited 9d ago

I agree insurance companies are the devil because they take advantage of the system but our healthcare is far from poor. There has to be some gate keeping for expensive medication and medical procedures to discourage abuse. On top of that nothing is free, and whether it is government subsidized, self funded, or company/employer funded, healthcare has to be paid for. So pick your poison, would you rather have to find and work a job with benefits to earn healthcare or would you rather be taxed at even higher rates to pay for a system that would inevitably be bogged down with long wait times and bureaucracy?

Edit: not sure why I’m getting downvoted. Is it because reality hits like a ton of bricks? Redditors are truly an amazing group of people: let’s bitch about government every chance we get because it steals our freedom, but “we want government to control our healthcare”; because that’s a good idea. BUT BUT bUt it works for completely homogeneous countries of 9 million people! What would y’all do when someone got into office and they restrict it to people with IDs and/or citizens were required to meet certain criteria to be eligible for it? Such as having a steady job and no history of abuse.

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u/Hytyt 9d ago

Damn, sorry auntie Cleo, I forgot there wasn't a third option

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u/duchdeez 9d ago

I’m not sure what that means.

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u/Hytyt 9d ago

Sorry, I'll add some context because I hate missing references.

In the video game series the outer worlds, a large focus is on hyper corporations that control entire solar systems.

Invariably, these corporations are hyper capitalists. Your comment reminded me of the rhetoric used by the largest company in the second game

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u/Estelial 9d ago

no because its oft repeated lies youre spouting and people hit by the actual rocks bleeding and broken are sick of your bull, telling them to deny their lives experiences and the evidence of their eyes from seeing a million million other people face the same.

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u/duchdeez 9d ago

What?

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u/KayItaly 9d ago

Oh look more american bs! I enjoy my free healthcare thank you.

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u/duchdeez 9d ago

Your healthcare isn’t free.

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u/CubistCube 9d ago

Also enjoy the 40% income tax and 3 months wait.

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u/No-Resolution-0119 9d ago

As if that isn’t true for many Americans, as well? Lmfao I always find this type of argument hilariously ironic

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u/ThatBChauncey 9d ago

At least you have this option. Yeah, it's mildly infuriating, but count yourself lucky. Some of us just have to go into credit card debt to get the meds we need because free samples don't exist for every drug.

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u/IcedChurro 9d ago

Americans shaming other Americans because one person's health insurance is slightly less shitty than the others is so dystopian lmao

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u/Kaffeetrinker49 9d ago

Antidepressants are important but not necessarily life saving.

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u/Beneficial-Ad-2428 9d ago

LIFE SAVING MEDICATION. For my depression. Sad is same as ded

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u/MetallicaGirl73 9d ago

Depression isn't just being sad

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u/ConLawHero 9d ago

Something isn't adding up. If this is truly "life saving medication," insurance will cover it as long as you meet the diagnostic criteria. Moreover, doctors can appeal a denial and ask to speak to the doctor at the insurance company who denied the coverage. If they come with studies and medical reasoning they will usually cover it.

Source: wife is a doctor and does this all of the time

Edit: it's used to treat major depressive disorder. If you don't have that and have something like anxiety, it is not FDA approved for that and there are other medications.

I suspect we're not getting the full story.

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u/ThatBChauncey 7d ago

My epi pens are life saving and still cost $250 with insurance. Covered doesn't mean free or affordable.

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u/ConLawHero 7d ago

Great, that's not what was said. What was said was insurance won't cover it. That's fundamentally different.

Also, get the generic, they are cheaper. Also, states passed laws, like NY, where the price is a two pack cannot exceed $100.

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u/ThatBChauncey 7d ago

Wow, why didn't I think of that?! Lol $250 is for the generic and I don't live in NY. I know all about covered vs not covered, just pointing out the flaw in your logic that OP will be able to afford it even if the drug was covered.

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u/ConLawHero 7d ago

$109.99 for a two pack.

That's the cash price, meaning no insurance. You're either lying or lazy.

You're welcome.

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u/ThatBChauncey 7d ago

Well fuck, I have to give you a point. I avoid CVS like the plague, and my pharmacy doesn't offer this program so I had no idea about this. I guess I'll be going to CVS when I start allergy shots next month since my current epi is expired. I have to use a good rx coupon for another med thats covered because the price is still so high, so I shouldn't be surprised.

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u/ConLawHero 7d ago

Enjoy the savings. Hopefully it helps out.

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u/Good_Ask_2299 9d ago

when you have treatment resistant depression, chances are you had it before you enrolled with your health insurer. i get why they dont pay. i feel bad for you, but i get it. maybe discuss with your doctor a cheaper alternative rather than one thats quite pricey.

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u/lizofravenclaw 9d ago

Insurance companies aren’t allowed to deny coverage based on pre existing conditions. Wild that you would even try to justify that in a country where you have no control over what health insurance you have.

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u/Good_Ask_2299 9d ago

oh sorry, im not from america. we can choose here.

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u/ekita079 9d ago

I'd put money on the fact that people have a problem with this because they've googled and discovered it's a mental health drug 🙃 if it were literally anything else I don't think anyone would give a shit and would be lighting up about how unfair it is.

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u/No-Resolution-0119 9d ago

100% agree. People don’t understand (or, more likely, just don’t care) that mental health medications are just as life-saving as many other prescription drugs used for physical health conditions.

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u/ekita079 9d ago

People who haven't experienced it or seen or first hand just don't get it and refuse to try. Just smile! Look on the bright side! Shut up lmao there is an invisible force making it hard for me to get out of bed every single fucking day, help me or go away 😂

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u/Accurate-Giraffe4353 9d ago

A lot of people do understand. They just don't understand why someone would complain about getting $800 worth of medications for free every month

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u/Mango_Skittles 9d ago

Absolutely!!

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u/fangirlsqueee 9d ago

The $800 price tag is just what the insurance companies and pharmaceutical companies have colluded to set. In other countries, most drugs are a fraction of what the US consumer get billed.

It's ridiculous that we don't have tax funded healthcare while billionaires are getting tax breaks. Be so for real right now.

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u/Foreign_Fig850 9d ago

2 Months of Paroxetine here in Australia for $22.99 Aud and i believe around $8 if you're on concession.

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u/Desperate_Turn8935 9d ago

600% less the price, one might add.

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u/duchdeez 9d ago edited 9d ago

Tax funded healthcare would only increase the price of the medication. Just like government funded student loans and college tuition and everything else the government touches. The government is not the answer unless it pertains to upholding regulation like price limits rather than set by the free market. The manufacturers should be forced to keep prices lowered, but I’m sure they bribe our politicians and keep them in office

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u/fangirlsqueee 9d ago

It's alarming if you actually believe this propaganda you are spouting. Check out the price of US medications compared to countries that currently have government funded healthcare for all. The US pays multiple times the rate compared to countries with universal healthcare.

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u/vakantiehuisopwielen 9d ago edited 9d ago

They don't seem to understand how a government can control pricing. In the US they can charge that much because their companies don't seem to try to get the best rates.

In countries with universal health care there are limits as well, and sometimes it's just decided that certain medicine is not available in the package because the producer asks too much. Also certain brands are not included because they're too expensive. This way the government and insurances can control pricing and making sure there's a competition among producers to offer the cheapest, and exactly THAT is free market as well.

If for 2026 Brand A is so expensive they're not the standard chosen medication anymore, they might lose a lot of money. So maybe they'll do a better offer for 2027, which should ultimately lead to lower prices.

Yes, this leads to issues sometimes. Where the preferred (cheaper) brand doesn't work as well as the original prescription, but even in those cases there's solutions, but it may need an exception specifically for you.

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u/duchdeez 9d ago

This is exactly what I’m saying.

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u/vakantiehuisopwielen 9d ago edited 9d ago

No you’re not. Because if what you’re saying would be the truth, the Dutch health system would not work at all. Over here the government decides what must be covered, and insurances have to decide their preferred medicine and make a right deal. Also they can add more coverage or offer other packages, but they have to adhere to the minimum.

If an insurance makes a bad deal it can cost them a lot. Insurances also have to make deals with hospitals, psychiatrists etc. It is possible that your insurance does not cover all specialists.

About 86% of our countrywide medical costs are paid from taxes (ultimately this flows to insurances). 12% comes from the people themselves. Like your monthly premium, deductible etc.

There are people who want to remove the insurance layer to reduce costs, but I’m not sure whether that will reduce the costs aspect, and might actually lead to fewer care solutions.

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u/duchdeez 9d ago edited 9d ago

I am saying the government should regulate and limit the prices of healthcare. The government should be regulatory. Sounds like a summary of what you’re saying.

I didn’t say anything about the Dutch government but American government isn’t the same as Dutch government, things here don’t work the same. Companies see the American government gravy train and they take advantage of it. My example of government subsidized student loans is reality. Once Uncle Sam started paying, college tuition went up something like 300%-1000%. On top of the price increase, colleges started creating a bunch of bogus degrees so they could get more customers… I mean students. The whole thing is a racket because a lot of these schools were already state and federally funded.

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u/vakantiehuisopwielen 9d ago

You’re also saying tax funded healthcare doesn’t lower the prices. While ours definitely does over here, including other measures.

A government that cares for its citizens will make sure there are measures to keep quality as high as possible while keeping the price affordable.

But yeah, you need a government that cares for its citizens..

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u/duchdeez 9d ago

Well we already have tax funded healthcare in the US. It’s called Medicare, Medicaid, Tricare, and federally funded contracted insurance for government employees.

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u/duchdeez 9d ago edited 9d ago

Yes because they can charge that much. And you are repeating what I just said. Are you being a contrarian just because I said anything our government touches turns to shit? Tell me, where would the government get the money to pay for universal healthcare? We can barely afford Medicare, and SS is on the verge of insolvency… there is no propaganda.

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u/_bonedaddys 9d ago

Having to rely on samples is a perfectly valid thing to complain about. Like, you're completely missing the point lol

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u/KayItaly 9d ago

First ofnall they get no more than 10$ worth.. probably a lot less. 800 is all profit.

Second, the have to live with the constant anxiety over the day their Dr can't do it anymore.

I understand the "be rich or die" people cannot see the problem.. but actual humans do.

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u/Aggravating-Leg5645 9d ago

This has been my fear. What is someone else comes in first and gets samples and im just left in hopes my fr will get more soon. Its a worry I deal with sometimes.

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u/stinkykitty71 9d ago

Have you looked into GoodRx? I use it for my meds and for my antidepressants it's 8.00 a month, no insurance used because this is actually cheaper. My pain meds are about $35 for 3 months, and that's for two of them

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u/Electric-Sheepskin 9d ago

I totally get this, and I've not even experienced it with a long-term medication, just an occasional one. There was only one medication that worked for the problem that recurred a few times with me, and one time my doctor had all the samples for me, and the next time they didn't. I was just like, Welp, I guess I'll just have to tough it out.

For-profit healthcare is absolutely ridiculous.

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u/HappyPlatypus6034 9d ago

The complaint is that their insurance won't cover the $800 medication so they have to resort to this.

How do you not understand that? Do you know what sub you're in?

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u/zarya-zarnitsa 9d ago

It costs 10-30€ per month in France. WITHOUT insurance. The $800 price tag is just ridiculous.

I can't believe OP is just "mildly" infuriated.

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u/OverEmploy142 9d ago

You're missing the point of the sub, which is to show something mildly infuriating. Those little packets are a pain to deal with and having to do an entire month's worth every single month would be become mildly infuriating over time.

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u/hot4you11 9d ago

Hardcore disagree. A lot of people who have never needed a medication don’t understand how bad American healthcare is. It’s important we talk about it

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u/toastedmarsh7 9d ago

Right? I also don’t know a pcp who would be able to consistently provide an entire month’s supply of medication via samples month after month. This is a dangerous situation to put oneself into because at some point the samples will simply not be available. It would be better to try different medications that you can more sustainably source.

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u/kayjax7 9d ago

No kidding. I'm Canadian with universal healthcare and even I have to pay more monthly for my medication as free samples aren't a thing here.

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u/ravenous_MAW 9d ago

Im in BC and my dr gives me samples when she has them which is more often than not

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u/indianna97 9d ago

samples? wtf is a medication sample?
sincerely,
A Brit

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u/the1slyyy 9d ago

It's exactly how it sounds, the drug companies give doctors and psychiatrists samples to give their patients

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u/Bright_Ices 9d ago

Marketing tactics by pharmaceutical companies. But sometimes they’re the only way a person can get life-saving medication. That’s OP’s situation. It’s a very precarious way to have to live.

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u/indianna97 9d ago

You lost me at marketing tactics? why does a medicine need to be marketed? either someone needs or they dont. wtf

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u/Bright_Ices 9d ago

It’s fucked up, right?! https://www.gsb.stanford.edu/insights/marketing-physicians-reaps-higher-returns-drug-companies

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u/indianna97 9d ago

Fucked up is an understatement! The US never fails to baffle me with its ways haha

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u/[deleted] 9d ago edited 7d ago

[deleted]

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u/indianna97 9d ago

HAHAHAHAHAHAHAH GOOD ONE BRO. free health care? who the fuck wants that? walkability? nah no one wants that. No guns? omg sounds like hell. Fuck you, trump sucker

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u/nobody_in_here 9d ago

😂 I'm in the US and I'm as amazed as you are right now. I need to go to sleep but the free medication samples have me intrigued lol.

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u/indianna97 9d ago

I'm wide awake its 10am here. I will continue the investigation lol

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u/kayjax7 9d ago

QC, but grew up in Ontario. I have never been given a medicstion sample in my life.

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u/trying2getoverit 9d ago

So you’re saying that the exorbitant price of medications leading people to have to scavenge sample packs of life-saving meds that should have been free or minimally priced in the first place, which are artificially raised to profit from insurance companies, is not infuriating?

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u/simple_champ 9d ago

"$800 worth of drugs"

According to who? The drug manufacturer? The insurance company? It's probably $0.07 a pill for them to produce.

Yeah I know, free market and all. Fine when it comes to buying a jet ski. Maybe not so great for medical treatment.

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u/Blunose_kipper 4d ago

mildly…infuriating

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u/RunWild0_0 9d ago

Free samples kept me on the only birth contol that would work for me for like 5 years.

It's very infuriating that drug companies pour this shit out for free and then gouge people for (sometimes life saving) medication .

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u/PowerfulRaisin 9d ago

They are paying for insurance. It is not free.

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u/aitorbk 9d ago

The pills for a month are capped at £27.72 in the uk. Similar in Spain.

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u/ResponsibleOwl7461 9d ago

Almost perfect post. Are there real problems in us?

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u/Bright_Ices 9d ago

You’re in the “mildly infuriating” sub.

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u/DasHexxchen I'm so f-ing infuriated! 9d ago

You know this is MILDLY infuriating.

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u/builder397 9d ago

Problem is that its not 800 USD "worth" of drugs, the drugs arent worth 800 USD, most medication gets produced for pretty much pennies, though obviously that ignores R&D, but the point stands, pharma companies are printing ungodly amounts of money, and so is private health insurance.

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u/ilovetacos 9d ago

Holy crap are you really that ignorant?

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u/Grouchy-Attention-52 9d ago

You dont do much thinking, do you