tl;dr my insurance company (Blue Cross Blue Shield HMO) has balked and dug their feet in and refused to cover medications far less radical than the FDA-approved ketamine nasal spray that my psychiatrist thinks will really help me. What sort of obstacles should I expect from the company, and what actions can I take to force my insurance to cover this treatment?
So the ketamine nasal spray treatment has been shown to have fantastic results for those of us with treatment resistant depression, and at this point, 10 years after I first started seeking treatment, I’m at the end of my rope. The usual antidepressants just don’t do it for me; for the past decade, I’ve been cycling medications with a huge assortment of add-ons. SSRIs only make things worse; SNRIs have had the best results, but they’ve really only made it possible for me to FUNCTION, and nothing else. I’ve had several different antipsychotics or mood stabilizers added on top of the SNRI baseline. But since my depression is treatment resistant, every 3-6 months I’m back in my psych’s office to increase the dosage and/or to try some other new drug on top.
I feel like if I can’t find anything pretty soon, I’m almost certain to just…give up, and allow the suicide monster to finally come for me.
As stated in the title, my psychiatrist thinks that the new-ish ketamine nasal spray infusion could help me out a lot. However, since this treatment is relatively new, and is pretty radical compared to simple antidepressants, I’m pretty sure my insurance will do everything in its power to keep collecting my money while giving me NONE of the coverage I’m supposed to get.
I have a Blue Cross Blue Shield HMO plan, and I’ve had A TON OF PROBLEMS with them over far less radical medications, so it can be pretty much assured they won’t even CONSIDER the esketamine spray. So, before I enter into the quagmire, before my psych even begins the process, i want to know what my options are.
What sort of things should I plan to do to force them to ACTUALLY PROVIDE THE COVERAGE I PAY FOR? What sort of roadblocks should I expect to see during this process?
Thank you, all
submitted by /u/Nuclear_Nihilist
[link] [comments]tl;dr my insurance company (Blue Cross Blue Shield HMO) has balked and dug their feet in and refused to cover medications far less radical than the FDA-approved ketamine nasal spray that my psychiatrist thinks will really help me. What sort of obstacles should I expect from the company, and what actions can I take to force my insurance to cover this treatment? So the ketamine nasal spray treatment has been shown to have fantastic results for those of us with treatment resistant depression, and at this point, 10 years after I first started seeking treatment, I’m at the end of my rope. The usual antidepressants just don’t do it for me; for the past decade, I’ve been cycling medications with a huge assortment of add-ons. SSRIs only make things worse; SNRIs have had the best results, but they’ve really only made it possible for me to FUNCTION, and nothing else. I’ve had several different antipsychotics or mood stabilizers added on top of the SNRI baseline. But since my depression is treatment resistant, every 3-6 months I’m back in my psych’s office to increase the dosage and/or to try some other new drug on top. I feel like if I can’t find anything pretty soon, I’m almost certain to just…give up, and allow the suicide monster to finally come for me. As stated in the title, my psychiatrist thinks that the new-ish ketamine nasal spray infusion could help me out a lot. However, since this treatment is relatively new, and is pretty radical compared to simple antidepressants, I’m pretty sure my insurance will do everything in its power to keep collecting my money while giving me NONE of the coverage I’m supposed to get. I have a Blue Cross Blue Shield HMO plan, and I’ve had A TON OF PROBLEMS with them over far less radical medications, so it can be pretty much assured they won’t even CONSIDER the esketamine spray. So, before I enter into the quagmire, before my psych even begins the process, i want to know what my options are. What sort of things should I plan to do to force them to ACTUALLY PROVIDE THE COVERAGE I PAY FOR? What sort of roadblocks should I expect to see during this process? Thank you, all submitted by /u/Nuclear_Nihilist [link] [comments]Read Morer/HealthInsurance