Lack of Access

I’ve been without my 10 milligrams Escitalopram for a few days, and the withdrawal effects are driving me crazy. My head feels heavy and my stomach is turning. The worst part is that I’m struggling to access to my medication despite that I’m on Medi-Cal. For international readers, Medi-Cal is free or low-cost health coverage for children and adults in California with limited income and resources. I work part time at a school so I’m unable to get coverage through work, which is annoying, but I’m able to live with it.

I’m unable to access to my medication because the health insurance plan provider where I receive my Medi-Cal, Anthem Blue Cross, does not cover Escitalopram but a similar medication Citalopram. I’m not able to switch out Escitalopram for Citalopram because I do not have a prescription for the latter even though they are basically the same! It makes me frustrated because Medi-Cal covered the last two brand name (Lexapro) Escitalopram refills I’ve had; I don’t know why they aren’t doing it now.

My thoughts are whirling, I can’t think straight. I’m just pissed at myself and the fragmentation of the United States healthcare system. I knew my medication was diminishing, and that I should have called into the pharmacy earlier. I thought I could get it right after I ran out because that’s what happened with my last two refills on Medi-Cal. I didn’t expect an access debacle. It started with my regular pharmacy, Walgreens, calling me and saying they aren’t able to provide  my medication anymore because they are not in my Medi-Cal health insurance provider, Anthem Blue Cross’s, network. The Walgreens pharmacist suggested I do a medication transfer to Rite-Aid or Walmart pharmacies since they are part of Anthem Blue Cross’s network. So I run around to Rite-Aid and Ralph’s, pharmacies in the health plan network, and they didn’t work. Mr. Squigglekins, who was researching pharmacies in Anthem Blue Cross’s network for the medication, found that they did not cover Escitalopram but its sibling Citalopram.  The weird part is that even though Anthem Blue Cross doesn’t cover Escitalopram, but its partner network, L.A. Care Health Plan, which I’m also part of, covers it. So, I’m not sure what to do. Why does one health plan not cover a particular medication, but another does? Can I still access Escitalopram or do I have to change to Citalopram? I’m too confused. 

The positive note is I’m seeing my psychiatrist soon, so I’ll tell him to prescribe me Citalopram instead of Escitalopram since it’s not covered by Anthem Blue Cross. Meanwhile, I’ll go to my local mental health urgent care center when it opens. Meh.

 

3 thoughts on “Lack of Access

  1. I’m sorry you have to go through this. Withdrawals are awful. I went through a day of withdrawals from Effexor last week which has very bad and quick withdrawals, it wasn’t fun. Something needs to be done about the US healthcare system. It’s not fair that people don’t even get their medications on time because of stupid technicalities. It’s so messed up. I hope you can get your medications soon! Could you possibly call your psychiatrist to order you some Citalopram now?

    1. So my debacle is already solved, and I managed to retrieve my medication. This is part of a three part posts that I wrote during the time I was going through it. Answering your question, my psychiatrist wasn’t there at his office when this post was written unfortunately. Thank you for your concern and sentiments.

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