My pdoc and I sent in the paperwork for me to get Emsam through patient assistance last week. Insurance doesn't cover it and it's around $2200/month which obviously I cannot pay. It's also the only AD that ever really worked for me and I've been on it 16 years now. I've gotten it through patient assistance since 2012 and have had insurance since 2014. I was expecting it to go through easily like every other time.

Instead I got an email from my pdoc today that didn't make sense. Until I asked her and she sent me the denial letter that just says "denied. Insured". I did really well not panicking (because she'd given me a plan to deal with it and I know she'll fight for me) so I called the company and it turns out that they have a new computer system that auto-denies if there is a reason to deny. They are hand-reviewing it and I should hear in a day or two if it was approved. The person I spoke to sounded like it will go through so again, not panicking yet.

I don't know what happens if it's denied. I don't really want to be on an old MAOI but the MAOI works so well for me. The only ADs I've not been on are cymbalta and the one that is something like tritenellix and the other MAOIs. Changing nearly certainly would mean an IP stay and I've done so well with avoiding those. In February it will have been 10 years. Mostly though I just don't want the old MAOIs. The food restrictions are greater, at least one causes weight gain that I do not need and they have to be taken during the day. I'm doing pretty well at taking AM meds for the first time since I was working in 2011 but it's hard for me. Adding a mid-day dose would be a real challenge. I know lots of you take meds 3-4x/day anda I really admire you for it. It's just not something I've done well at in the past and I don't really know why.

I hope I don't have to worry about this. I'm trying very hard to stay calm. Like I said my pdoc will fight for me and the company was very willing to work with me. It's just hard to focus on the now and not the "what if?".