- Have you ever had to go a day or more without your prescription medication?
- Do you know the physical discomfort and anxiousness of waiting to get the medication reordered?
- Have you spent hours on the phone with the doctor’s office, insurance company or pharmacy waiting for your ADHD medications to be filled?
If so, you, like me, have been trapped in the medication maze.
For years I have listened as clients told me about their challenges to be diagnosed, only to have their hopes dashed when they find themselves trapped in the ADHD medication maze. What is the ADHD medication maze? It is that tangled cycle of trying to get ADHD medications refilled. Prescriptions not relayed to local pharmacies or faxes getting lost to online medication mailing systems. Suspicious looks from pharmacists when picking up medications. Refusals by insurance companies to pay for prescribed medications. The countless dead ends, backtracking, twists and turns of getting a written prescription through the process and have it filled. The ADHD medication maze is a frustrating web where so many people with ADHD find themselves stuck not knowing which way to turn and unfortunately many give up and never get a chance to experience the possible benefits of ADHD medications.
In theory, filling medication prescriptions is supposed to be easy work. In reality, it rarely goes smoothly. Let me tell you about my own recent experience with trying to get my medications filled. I know many of you will relate.
I called to make an appointment and a month later got in to see my doctor who, after a 25-minute wait and a 10-minute appointment, prescribed me my medications. As I left the clinic, I was told a 14-day short-term prescription would be called to my local pharmacy and an email/fax would be sent to Express Scripts, my mail-order pharmacy. Okey dokey.
Not so bad. Except (you saw this coming, didn’t you?) a plan is only as good as its execution.
The following day my local pharmacy auto responder called (nice feature by the way) to let me know my short-term interim medications were ready to be picked up. I was pleasantly relieved and somewhat surprised it had been that uncomplicated. Easy peazy, I thought. I will pick them up on my way to the airport and just to be sure, allow 15 minutes extra.
You see where this is going, right?
I arrived at the pharmacy with plenty of time, trying to have faith and confidence in the system…after all they had confirmed my prescription was ready for pick up, right? I waited patiently in line for the two people before me to pick up their prescriptions and have a pharmacy consult…do dee do…no worries, plenty of time.
My turn. I stepped up, gave the pharmacist my name and they turned around to reach for my prescription. The pharmacist placed two bags on the counter, rang me up…my cost was under $10 dollars…Yay! Woo Hoo…happy dance. I even scolded myself for doubting all would work out.
And then…
Wait a minute. I had three prescriptions. “Uh hello Mr. Pharmacy Man, I’m supposed to have three medications filled today…there are only two.”
At this point I was still hopeful…wanting to trust in this “fill a pill system” and then I heard those fated words…”The doctor reordered three medications, but the XYZase is not covered by your insurance until the first of next month.”
Wait what?
And then, in a nanosecond, my stomach dropped, my pulse quickened and I began to see red. I was frustrated by the whole system. Frustrated because I trusted everyone to do their job. Angry with the realization that so many people get stuck in this medication maze with little support or map to find their way out…
Side note: I’ll admit it…I have a real problem with the way medications are dispensed in this country. It’s a crazy system, full of twists and turns we are expected to navigate in order to get prescriptions filled. It’s complicated by monetarily motivated insurance companies who decide what medical care I receive and what I don’t. Last time I checked, insurance companies do not have a medical license; they don’t have the training to decide whether I continue on a medication or not. My doctor with the advanced M.D. degree should be the one to decide medically what is in the best interest of my health.
So where was I …oh yes, standing at the pick-up counter at the pharmacy…
Mustering my courage and trying very hard not to be rude, I told the pharmacist that “the insurance company did not get to decide my medical care, my doctor did and I would pay for that prescription out of my own pocket if needed…thank you.” Then, I was asked to step out of the line and told my prescription would be filled as soon as possible.
So I waited…I don’t mind waiting…after all I had allowed an extra 15 minutes just in case. So I waited while the pharmacist filled other prescriptions, answered three phone calls…and a half hour later and 8 people less in line, the pharmacy assistant grabbed the coveted white bag, looked at me and said “it’s ready.”
Not trusting myself to say a word, fuming with the needless half hour wait, the senselessness of our insurance companies dictating our medical care and the realization of so many other people going through similar experiences…I paid the $25 for my medication and left.
Two weeks later, my interim medication bottles were almost empty, but my Express script online mail prescriptions were scheduled to arrive. (Insert laugh track.)
Yep…you guessed it…no white plastic bag with jingling pill bottles had yet graced my mailbox. I was a day away from my medications running out a second time that month.
Curses…here we go again! Who knew what had happened this time? So once again I was on the phone calling my mail-order pharmacy to see if they had received the refill order from my doc…nope they hadn’t received it. I called the doctor’s office again… “oops”…they had emailed my local pharmacy the short-term refill (we all know how that went), but “sorry” the email/fax with the prescription to my mail-order pharmacy hadn’t been sent. Do I need them to do it now?
People! Work with me here! I’m doing all I can…I need you to follow through. Who in their right mind would ever go through this craziness over and over again if their medication wasn’t necessary?
The fact is I know so many of you go through this confusing, exhausting medication maze…month after month, year after year. You bravely and boldly step into the process where you almost need a medical degree yourself to get prescriptions filled. It is ineffective, inefficient, and, unfortunately, it is what we are left to work with.
We cannot escape it…so if you have found yourself in the medication maze, here are some tools to sustain you when you find yourself in this labyrinth:
- Remember – you and your doctor get to decide your medical treatment.
- Your insurance company refusing to pay for a medication doesn’t mean you can’t pay for it out of your own pocket. I know some medications are costly, however, you might be surprised at how inexpensive some really are. Always ask.
- Always double and triple check to make sure emails/faxes/phone calls have been made/sent and received so the delivery of your medications goes as smoothly as possible. Specifically call the pharmacy and your medication-mailing service to confirm they received the prescription orders…. if not, call your doctor’s office to make sure they were sent. Don’t assume.
- Keep the doctor’s office, pharmacy and mail delivery systems numbers where they can be easily found.
- Don’t give up. Remember the benefits of your medication far outweigh the frustration to get them.
The confusing, exhausting medication maze is an all too common problem those with ADHD face. I understand your frustrations and admire your courage to go forth despite the craziness of it all! I’ll bet you have some “medication maze” stories of your own…I’d love to hear them!
Okay, rant over. 😉
Want to learn other strategies about maximizing the effectiveness of your medications, ways to talk to your prescriber so he listens, and gain an understanding of how medications work? Join me for my 5 week teleclass – Minimize the Madness: Taking the Mystery Out of ADHD Medication – starts Monday, April 2nd. Register today!
I don’t know what meds you’re getting, but when I have to pay out of pocket it cost between $100 – $250 per medicine. For me that is a non-starter. I often have to go without meds or with meds that don’t work as well because the system thinks I’m some sort of drug addict. Even worse when I am on these sub-par meds I function sub-par, which puts me at risk for losing my job. I can’t just go to my boss and say, “I’m sorry I can’t meet my deadline, I don’t have my meds.” I was diagnosed with ADHD at age five and have been on meds since age 6, they help SO much, but the system causes me terrible amounts of stress and worry. I’m 25 years old so I get to look forward to another 65 years of this crap. It’s no wonder there is such a mental health / homeless problem in the United States, the system punishes those that are less functional and in need.
Thank you for writing this piece. I know it is old but still HIGHLY applicable, not only the US but in South Africa too. I have HUGE problems getting my scripts and meds timeously, incompetent doctors just couldnt be bothered to ensure scripts are written in time. It is such a frustration and absolutely rage inducing!! I have now run out of meds, and have had to take time off work while my clown of a doctor takes DAYS to print out a script she has written every month for YEARS. Do they not appreciate how much of an effect running out of medication has?!?! We adhd sufferers are treated worse than drug addicts. My only consolation is my belief in karma and that in our next lives, perhaps I will be the doctor and my doctor will be the adhd patient waiting anxiously for a simple piece of paper. Ah well maybe I will get lucky and she will manage to do her job today!
Here is the story of my insurance coverage issue:
I was prescribed ninety 10mg Adderall immediate release capsules from my doctor. We dropped off the prescription paper at the drop-off booth at the pharmacy and returned about an hour later after getting some work done. So after waiting in line for almost half an hour the lady at the pick-up booth didn’t give me my medication but instead told me to move over to the guy at the drop-off booth which was strange. I was hoping the guy at the drop-off booth was going to give me the medication but the moment I saw his eyes I know there was a problem. He opened his mouth and said that the insurance company only covered 60 pills. So to get the 90 we would have to pay for 30 of the pills or wait for the pharmacy to call the doctor and the insurance company to see if we could get the full coverage of the 90 pills. I said I wanted the 90 pills because 60 pills would probably disappoint me. But then my dad standing next to me didn’t want to pay for the 30 so he told the clerk to try and get the full coverage. At that point I knew my dad ****ed me up. It’s been about 2 weeks now and there’s still no call for the full 90 pills coverage. My dad could have just paid the extra price that the insurance wouldn’t cover but he is one of the cheapest person in the world. Money isn’t even an issue for him because he makes about $50 an hour and over $100 an hour during overtime. I am still angry from my dad’s decision of waiting for the full coverage instead of paying the additional price to get it the same day. I also hate the insurance company for this trouble by taking a retardedly amount of time digging their noses while I suffer with adhd. The insurance company are purposely making me wait because they obviously don’t care about covering the full cost. They are dumb to only cover a partial amount of the medication even after the doctor who is an expert in adhd medication already confirmed the dosage. I am about certain that the only reason the insurance companies don’t completely cover adhd medication is because of money. Very few people give out free money so that’s the problem with society. Insurance companies are too good to be true because the only reason they exist is not to assist with your financial issues but to take money out your bank.