I got a letter today turning me down for Extended Health through Manulife’s UBC alumni health care program. My job does not have extended health. I tried to apply for Blue Cross, and they told me my pre-existing condition would not be covered for medication. Prior to this job, I was in school and then at a job with a health care plan. I never had trouble getting this medication before, and I’ve been on it since I was 19.
I have depression. I don’t have typical depression, nor is it situation. My depression leaves me non-functioning when it is not treated. I cannot stay awake, I cannot take care of myself and I have constant suicidal tendancies. Recognizing this, I’ve worked hard to be treated by psychiatrists and medication combined. I have been high functioning since being treated. I work, I pay taxes, and I no longer want to kill myself. Now, I cannot find coverage for my medication and I cannot afford it. I don’t understand how, in a country that supposedly has univeral medical coverage, I cannot be treated for my condition. I’m frustrated, and I’m almost out of medication, so now I’m also scared. How can this happen?
Rebekkah, sorry to hear about your difficulty! I have a family member who’s mentally ill and has to jump through a lot of bureaucratic hoops to get medication, so yeah, it’s a bitch.
It sounds as though your situation is partly due to the constraints of Alberta’s provincial health care coverage (I assume this because you give your location as Calgary), of which I found a discussion here. I presume that as in the US, different provinces have different levels and types of coverage (and medications for mental illness are generally tougher to get coverage for).
Are you eligible for the Non-Group Prescription Drug Coverage plan? That seems to be the only public prescription drug coverage for people who are under 65, not on income support, not students, etc. Of course, I’m no expert on any of this, so your best bet may be to find a mental-health information/service organization that can give you more informed answers. The Canadian Mental Health Association (Alberta) seems to have quite a bit of info.
Anyway, best of luck, and hang in there! (If worse comes to worst, aren’t all medications free of charge at hospitals? Can you go to a hospital emergency room and explain your situation?)
That truly sucks. Living in Alberta and having just gone through a flare-up of my anxiety disorder, it would be accurate to say that people with any kind of mental condition are not being looked after by Alberta’s healthcare system. I’m not sure where the bureaucrats are coming from, but in my world, mental health is part of my total health.
And that pre-existing condition not being covered thing? What kind of scam is that? Oh, the insurance industry kind. We only extend insurance to people who won’t use it. Gotcha.
Bottom line - don’t get sick in Alberta. It’s not good.
(Rebekkah - get over to the Grace Women’s Centre at the Foothills Hospital complex. They have fantastic resources that somehow haven’t been chopped by the gov’t yet. They might be able to find a resource for you that we don’t know about.)
It sucks, but the only people I’ve ever met who thought Canada had “universal medical coverage” were people who did not live in Canada. I thought everyone knew we didn’t have pharmacare.
Rebekkah, time to go hunting for a job with a decent drug plan. Man, I don’t know how anyone survives without a good drug plan. They’re insanely expensive. I feel your pain.
I am confused. You’re applying through a UBC plan, yet you live in Alberta?
And, Canada DOES have Universal Health Care, in comparison to what there is available here. Everyone gets basic medical care without having to bankrupt themselves. Everyone = universal. In the US, I am paying $300/month for my coverage, plus $30 co-pay every time I go to the doctor. I would take basic old AHC over this any day of the week.
I’ve had health issues since I was 19 and I’ve experienced some frustrations along the way as well. Some tips that have helped in the past: Telling your doctor you can’t afford prescriptions may result in free samples a good portion of the time. Psychiatric visits (though not psychologist visits or counselling) should be covered by regular health care (no guarantee on amount of time for a referral). Psychiatrists are also frequently in possession of free samples of prescriptions they can give out.
I quickly found a job with extended medical coverage. No matter how fabulous a job may look, if they can’t give me precription coverage, I can’t work for them. Bottom line.
I do wish each province had pharmacare for those who live under the poverty line but are not on social assistance or senior citizens (Manitoba was the only province I have lived in that offered that.) And of course I do not expect the government to offer prescription care to anyone regardless of financial situation. The health care system would collapse.
I’m very lucky to live in Canada. If I had to pay for doctor’s office visits, hospital visits, surgery, etc., I would be homeless.
I don’t want to hijack the thread, and seeing as how Rebekkah is in Canada and not the US I can’t offer any Rx help, but this attitude really irks me. Why should insurance companies provide you (generic you) coverage at the same rate as me (generic me) if I’m healthy (now, I might get sick later-that’s why I’m buying health insurance) and they know you’re going to go out and cost them thousands of dollars right off the bat? It’s akin to not carrying car insurance and then, just as your car goes into a spin towards a tree, you grab your cell phone, pick up coverage and expect them to pay 20K to replace your car.
Rebekkah, I hope you find something soon. Explain your situation to your doc and ask him/her if he/she has any sample meds to tide you over. Docs tend to be pretty reasonable about that kind of stuff.
If it’s a pre-existing condition, then it’s no longer insurance, now is it? Why would they agree to have you pay $100 a month if they know you’re going to cost them $500 a month? That makes no sense.
Kimstu, thank you for the links. I will look through them tonight
Featherlou, it’s nice to hear from a fellow cow-towner who knows what I’m going through. I think mental health is extremely over-looked, and my experience has been a “just get over it” attitude from health professionals that aren’t psychiatrists. When I finally got into a psych, and he explained for an hour how brain chemistry works and that this wasn’t something I could just get over, I finally knew how important it was to stay on my meds. I will contact Grace asap.
RickJay, I am contemplating talking to my boss and explaining my position. He considers me valuable, and as we are a small office, he may consider picking up the extra cost to keep me around. Otherwise, yes, eventually I’ll have to go. Sucks though, because the job is great.
GingerOfTheNorth:
I am applying through a UBC alumni program which covers alumni without health care through jobs.
Maybe this is a Canadian attitude, but for me universal health care includes FULL health care. Paying 300+ a month to have prescriptions covered that maintain basic functionality is ridiculous. I would never tolerate that, and I certainly don’t think I’m lucky because I get the basics for only $45/month. I think I pay taxes and live in a country that affords universal health care, and I am willing to pay the $60 additional a month for extended health, but I do NOT expect an illness previously covered under the same Blue Cross coverage to be excluded because I left the job. It’s silly as far as I’m concerned.
Cyros, I’m going to the emergency psych office asap to ask them about this. The first psych I had gave me three months of the meds I’m on now, so hopefully they can do the same.
Weirdave, I appreciate the sentiment you have, however I do disagree. I believe that society exists to help everyone, and universal medical is a part of this. Just as I’m willing to pay my taxes knowing someone who needs welfare will get it, but that I will likely not need that benefit, I expect my medical needs to be covered in lieu of someone else who doesn’t require the same level of care. This is the abiding idea of universal health as far as I’m concerned. And, I might add, my condition is one of the few pre-existing conditions excluded. I take issue with that.
Neurotik, it’s a government regulated prescription drug plan that you pay into. We have universal health care here, so yes, it’s a losing proposition for them as far as I’m concerned. But, Canada professes to support universally accesible medical service, and I’ve had this since I was a kid. If I went to a job with a group health care plan, this medicine would be covered. Because I’m not in a group it isn’t. This seems arbitrary to me.
Everyones input is appreciated, deeply. This is a stressful situation for me, and I really am greatful for the opportunity to rant!
Sorry I didn’t hang around and reply earlier. My roomate took me out to see Bob Saget do standup, and he was SUPRISINGLY funny. And dirty.
Can I ask what the difference in price is between the premiums and your meds?
Also, can I ask what you’re taking? I’m on a number of psychiatric meds as well, and sometimes there are cheaper alternatives.
(In case you haven’t read the million other mental health threads I’ve been in lately, I’m studying for my doctorate in psychology, and I have bipolar disorder. I know some stuff and am happy to help you figure out where to go next.)
Rebekkah, my comments were directed more towards people who get their health insurance from private companies. I recognize that a government entitlement program is an ntirely different kettle of fish.
Weirddave, part of my attitude towards insurance crap is from watching my boss, a very nice man, fight to get insurance for his small business because he had the audacity to actually make a valid claim on his insurance, which they then promptly cancelled. Another part of my attitude is the Alberta auto insurance business, which is one of the biggest scams around. I can see your point, but I don’t see the point of insurance only being for people who never collect it, which is how insurance companies want it to be - you pay in, but you never take money out. I’m starting to think that insurance should be not-for-profit (yes, I know, blasphemy.)
Rebekkah, if you’re interested, there are some great self-help resources for people suffering from depression that you can use in conjunction with meds. If you would like more info, please send me an email at featherlou@yahoo.com.
Lol, Featherlou… your comment and my situation is made all the more ridiculous when you consider that I’m an Insurance Broker! I’ve seen the shit going on with insurance, and I feel your bosses pain! I’m new to the province, coming from BC that has a public insurance program. I do believe that alberta auto insurance is a giant scam. I DEFINATELY believe in government auto insurance, having experience both sides of the coin, although ICBC can hardly be called not for profit. When I studied for my insurance license, they pushed the idea that insurance was a group calamity coverage. The main idea is that everyone pays in, on the premise that only the very few will need the coverage. Instead, reality is that everyone pays in, but anyone who claims on their insurance when they need it risks getting cancelled or faces really high premiums. Not the way it is supposed to be. The one thing I like about my job is that, because I’m a broker, I have the luxury of working on behalf of my clients, and shopping markets to find THEM the best rates. Few things in the job feel better than taking someone from a $5,000/month premium for their car to a $2,000 premium.
/hijack
And, thank you for giving me your e-mail. I’ve researched my condition for years, and I am one of those people who believes medication alone cannot treat the problem. However, because I suffer from a-typical depression, I have yet to find a resource applicable to my condition. Perhaps I should clarify here. The main symptom of my depression is extreme lethargy. My first “breakdown”, I slept for four days straight, and then went for three months working five hour shifts four times a week and sleeping every hour I wasn’t working, and on my breaks!. It felt like running a marathon to get in the shower, never mind combing my hair. Anyone whose experienced this has my sympathy, because it was utter hell. I barely made it out alive. When I’m not medicated, I can barely function. I fall asleep constantly, and because I have no energy reserve, I feel suicidal.
When I’m medicated, I have NO problems. I saw a psychiatrist mainly to establish an effective dose, and he told me that he didn’t think I would benefit from therapy beyond the work we did to normalize my day to day thought process.
Nonetheless, if you still think your resources can help in spite of this, let me know.
Is that really cheaper than a health insurance premium? That’s not bad, as far as meds go.
A lot of stuff has gone generic now, too, so if you’re thinking of trying a different anti-depressant, you might ask if trying Prozac or Wellbutrin is a good idea, both of which are now available in generic.
Heh. I’m in the U.S. I pay $375 a month, which is a steal when you consider that my meds alone would cost me over $400.
Sorry if I got confused for a minute.
Seriously, though, I have a couple of ideas:
I don’t know about Canada, but in the U.S., a lot of major hospitals have “free care” programs. They’re means-tested, but the test is much more lenient than the tests for Medicaid. I don’t know your financial situation, or whether free care exists in Canada, but if it does and you qualify, that can be a really good way to go.
You’re upset over having to pay $80/month??? Sorry, my empathy just dropped a lot. $80/month is nothing. A good health insurance plan costs much more than that (down here) each month. Acording to what you’ve said, you need this medicine to function, the alternative is an unlivable life. $2.66/ day seems a small price to pay to have a viable life. I thought you were on $5-600 a month of meds or something.
After reading that dollar figure I thought it might be what Rebekkah is paying as a premium… but some online searching turned up prices around $70 US for 90 pills, from 10 to 40 mg.
Seriously, shelling out $1000 a year does have an effect on your lifestyle, but out-of-pocket expenditures for something like diabetes are higher. If it’s something that puts you on the verge of bankruptcy, you need to meet with someone who can tell you how to control your spending.
I can understand having to pay more if I’m going to be at a higher risk of using far more services/dollars than other people. That’s fair. Outright denying me for health insurance because I have lupus (which does happen) would be far more terrible in my opinion than saying ‘Because your condition necessitates more care, you are considered a high risk patient and your premium will be higher.’ would be fine. I’m lucky, though. I have UPMC health insurance, which does not recognize pre-existing conditions. Although I’ve known I had lupus for four years, and have only had UPMC insurance for 2, everything relating to it is completely covered. My bennies cost $360/month, which my boss pays.
UPMC’s attitude is that it will be cheaper for them to maintain my present state of health than to allow lupus to be out of control and cause secondary health problems that they would have to cover.
To get my meds without insurance, one prescription would cost me $3.60 a pill. Times twice a day, every day. That’d be, for a regular 30 day supply, $216. Kinda puts into perspective the fact that I’ll pay $80/month for a month’s supply of 2 non formulary drugs without griping.
It’s usually a matter of priorities. Meds are just as much a necessity as buying food, paying the rent, having water, and clothes on your back.
When I couldn’t get the meds under insurance because of a screw up with paperwork, I paid for the most important meds outa my pocket. I could do it again, but I’m glad I don’t have to. Seriously though, 80$ a month is not that much. There are a lot of people who spend more than that on cable TV.
