On July 28th, I attempted to get a new Epipen. I ended up not getting it because it was too expensive. A new Epipen would cost me $351.73. That's about 30% of my paycheck. The reality of my situation is that if I purchased it, I would not have had enough money for food.
|I can't afford my life saving medicine. I could die.|
I didn't think it would be so expensive. I have health insurance that I get through my job. I pay $135 a month for my portion of the insurance plan. I thought it would cover life-saving medicine like my Epipen. I called Aetna, my health insurance provider. I talked to Customer Service, and they transferred me to Prescription Customer Service. The Aetna Prescription lady explained to me that my Epipen was considered part of my deductible.
'What? How can life saving medicine be part of my deductible?' I exclaimed loudly over the phone. I really was hoping that this was a mistake, and they'd tell me they realized this was an error, and cover the Epipen.
I studied the plans carefully when I signed up last year. I remember the $2500 deductible for health care services, such as hospital stays. I remember looking over the prescription drug coverage, and I do not remember seeing anything that said that prescription medicine had any sort of deductible. I sadly accepted that I would just have to pay out of pocket each time when I saw my therapist & psychiatrist, because my plan said it applied to my deductible. I can only afford to see my therapist once a year these days. I probably need to see my therapist more than that because of what transpired next over the phone.
'I have prescription health care coverage! There is an Rx Bin number on my card! I've been paying $130 a month to Aetna for the past year and a half! How is it that Aetna is refusing to cover my life saving medicine?'
The Aetna prescription customer service lady gave me zero compassion. She told me that I needed to meet the deductible. Then she told me that I was halfway to meeting my deductible for the year. This wasn't a horrible mistake. My worthless Aetna health insurance wasn't going to help pay for an Epipen. And here I was, a severely allergic person walking around with expired medication that may not work. I was up shit creek without a paddle.
I felt the full horror of my situation. Having been diagnosed with Idiopathic Anaphylaxis in August of 2011, I don't even need to eat anything to bring it on, I could go into shock and die at any time for no reason. My only hope for survival was the Epipen, and I was not going to be able to afford an Epipen.
Shock, disbelief, and total hopeless abject terror, are some of the emotions that I felt initially. I felt like the lady had read me my death sentence. Fear quickly became replaced with anger, and outrage at the injustice of the situation. How dare Aetna take my money every month and then refuse to cover medication I needed to live. And then I yelled at the lady over the phone in anger. I do not remember what I said, I could have even said a swear word or two. I went full on CAPSLOCK OF RAGE on this lady. I think I remember telling her that I would tell the entire world about how Aetna was trying to kill me by refusing to cover the Epipen. And then I hung up.
I feel bad for yelling at the lady, because it wasn't her fault personally that she worked for an evil for-profit corporation that had just essentially condemned me to death. I am trying to avoid yelling at people in anger these days and handle my emotions with skill and equanimity. But in that moment of fear and horror, I absolutely lost my shit.
When I calmed down, I tried to find options to help me pay for my medicine. I called my doctor's office. The helpful lady at my allergists told me that a lot of their other patients were having trouble affording life saving epinephrine medications, and she could send me a couple of coupons for a small discount. She offered to ask the doctor to rewrite the prescription for a single Epipen. I told her that was not a good idea. My last anaphylactic reaction required 3 Epipen injections to stop my throat from closing up. My allergic reactions seem to be getting faster and more violent each time. What's the use of carrying a single dose, if it's not enough to save my life? She agreed and said she'd send me the coupons on Wednesday.
I went online and filled out an online form for a 0$ Copay 'free' Epipen on the Epipen website:
Because I have my crappy Aetna health insurance, and it covers prescription medication I qualified only for a $100 discount. But the fine print on that coupon said: This offer may not be combined with any other EpiPen coupon or savings offer. I wasn't going to be able to use the coupons my doctor's office was sending me. So my out of pocket cost for two new Epipens would only be reduced to $251.73. Could I swing that? Not really.
The manufacturers of the Epipen, Mylan, have a patient assistance program that helps people afford their Epipens. I called 1‑800‑395‑3376 and talked to a Mylan representative who asked me questions. I didn't qualify for help through Mylan's program because my health insurance included prescription drug coverage. What? No it doesn't! I mean, Aetna says I have prescription drug coverage, but it won't pay for my Epipens. So that phone call and Mylan's patient assistance program is worthless. You'd pretty much have to be homeless, and not have any sort of drug coverage to qualify.
Out of desperation I called the number on Healthcare.gov 1-800-318-2596
The lady was nice. She said that since I qualified for three dismal cheap plans through my employer, I did not qualify for any plans through ACA. Great. I told her my situation and she told me to call the State Office of Insurance for Washington at 1-800-562-6900.
They are open Monday through Friday and are closed today. I called and left a voice mail. I will blog again when I have an update. Thanks for reading. Please subscribe to my blog.