Just diagnosed. Irritated with meds and insurance

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    • #143637
      Jf67
      Participant

      Hi! I was just diagnosed this month.
      My doc put me on generic concerta
      18mg. The first 3 days were great.
      I thought I found my miracle drug.
      I could actually focus and the
      constant narrative in my head was
      gone. By the fourth day I noticed
      I was irritated and had periods of
      anger on and off throughout the day.
      I don’t want to be on a medication where I’m not sure if its gonna be a good day or a bad day on it. I know stimulants have potential bc the first 3 days were wonderful.
      I paid $100 for half of the script
      bc my insurance wanted doctor approval.
      After the 15 days I went to the
      pharmacy to refill. The pharmacist
      said the it was approved but bc it’s
      a tier 3 drug I had to pay a $210
      deductible and a $54 co pay (every month).
      HELLO, its a generic drug.
      I did extensive research with numerous pharmacy prices and insurance. It appears my
      best option is generic adderall ($1.67 co pay). It also doesn’t require a prior approval. My insurance only approves Ritalin IR (generic) & generic adderall.
      With approval they will cover vyvanse with a $79 co pay. Which is only $25 more then the generic Concerta.
      I still don’t understand why the co pay is $54. Its the same with any methylphenidate formulation.
      I wanted to talk to my doctor about
      changing it anyway but its difficult
      bc in the US there is such a stigma
      with adderall and I’m just uncomfortable with
      all these new prescription drug laws.
      I have never had an addiction problem but it sucks when you need to talk to your doc about a med change but have to fear you may be looked at like a “drug seeker”
      The pharmacist treated me like an
      addict when I went to fill my script. She was very rude. When she told me about the deductible and co pay she said ” you should expect this, you are trying to fill a narcotic script”
      It felt like I was treated like a
      criminal when I just want to try to
      better my quality of life.
      Anyway, has anyone had similar problems
      with generic concerta? Or similar
      Insurance issues.

      Thanks,

      Jamie

    • #143772
      Penny Williams
      Keymaster

      I’m sorry you’re finding getting ADHD treatment such a struggle — you’re not alone with this experience. It’s unfortunately the nature of the beast, especially now that there’s such a huge problem with stimulant abuse by folks who don’t have ADHD. I would talk to yur doctor about your experience and your struggle with the costs. If they seem to not “care,” then it may be time to find a new doc.

      Penny
      ADDitude Community Moderator, Parenting ADHD Coach & Author, Mom to teen w/ ADHD, LDs, and autism

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