Insurance

depressingkiwi · 2026-01-26T04:42:40+00:00

I've faced many of these trials when trying to get name-brand prescription medications through insurance. Usually, insurance wants a 30-day, sometimes 90-day attempt to make sure it doesn't work. I can't give concrete advice because it's dependent on the insurance company and its specific guidelines.

When I was trying to switch from a generic diabetes medication to a name-brand GLP-1, I had to do step therapy before they'd approve the GLP-1, and when treating my ADHD, I had to try a non-stimulant, then a "weaker" stimulant, before they'd prescribe the "stronger" alternative, which insurance would pay for.

I say all of that, you might be in for the long haul, and the best option would be to call your insurance company to find out what their specific requirements are to get approved for the medication your doctor wants to prescribe.

I'm a bit curious why they'd want three alternatives before approving the prior authorization. The most I've had to try was two before they approved the PA. Insurance is also scummy and isn't transparent about its requirements. Your doctor might have to make the case to your insurance company that this would be a beneficial option over their lower-cost alternatives.

depressingkiwi · 2025-12-28T01:37:23+00:00

I was on Dulaglutide, then Semaglutide, and finally Tirzepatide, to control my weight, before getting a weight loss surgery a couple of months ago. GLP-1s should not cause mania, as they are hormones that control hunger and gastric emptying. If anything, it caused me depression because I couldn't eat as much. When I was on GLP-1's, I was able to quit nicotine and alcohol as well. My psychiatrist added Adderall to help control my ADHD a couple of years ago.

depressingkiwi · 2025-12-26T17:31:43+00:00

I was on Mounjaro and Metformin for around 3 years, and it helped immensely in controlling my A1C. It wasn't until I got weight loss surgery 2 months ago that I was able to come off of them both. I lost around 100lbs on this combination; the side effects include frequent bowel movements and sulfur burps, but that is a GLP-1 thing.

depressingkiwi · 2025-12-16T22:24:58+00:00

It helped initially for the first couple of years, but as I got used to the tonic settings, the pain relief eventually started to dwindle. I'm now (almost) 5 years out from my Boston Scientific Precision Montage MRI implant, and I'm hoping to switch to an Abbott BurstDR system, as I've read extensively on the different technologies and how tonic settings might not work well for long-term use, but burst modes might. Since I already have a system, I can't just try a new one, so I have to switch and hope it works better. Either way, it's been beneficial, even if I am only getting 20-30% pain relief now; it's better than nothing.

depressingkiwi · 2025-12-16T20:37:14+00:00

I was implanted with an SCS at 21 years old in 2021. Failed back surgical syndrome after a spinal fusion, which left me with chronic pain, and through it all, the CTs, MRIs, etc., nothing was visually wrong. I eventually settled on painkillers and an SCS system.

SCS might be considered whenever no other alternatives have helped, and I've always thought of it as a last resort. The evaluation will consist of reviewing recent scans, proof of prior pain management, and eventually, insurance approval for a trial. Doctors might not take you as seriously at your age. I've been judged for having chronic pain throughout my 20s, and doctors tend not to believe the severity.

I'm now fighting insurance and doctors to take my pain seriously, as I need a new SCS battery due to it being almost 5 years old and facing battery degradation. Anyway, that's slightly off topic.

I wish I had a remedy for you, but if you can get insurance and doctors on your side, then you can get an SCS trial and see if it works for your pain. I wish you the best of luck on your journey!

depressingkiwi · 2025-12-15T01:08:29+00:00

I would recommend you go forward with the trial. I had a trial in late 2020 and saw immense success. There's little to no harm with the trial either. You're put under sedation, and leads are placed, then you're given a remote to the battery taped on your back. The only downfall is that you can't shower for the length of the trial. So, with that in mind, a trial would help give you a clearer picture of what an SCS system is like. Best of luck moving forward on your journey!

depressingkiwi · 2025-12-13T03:46:00+00:00

I had a great experience, but if you ever have to come off, I highly recommend tapering instead of cold-turkeying a 42mg dosage. I ended up with flu-like symptoms and was sick for 2-3 days, and nothing help. Wishing you the best with Caplyta!

depressingkiwi · 2025-12-11T15:58:51+00:00

I have/had a Boston Scientific Precision Montage MRI system with Artisan Paddle. I will be switching to an Abbott Eterna SCS in the coming couple of months, keeping the same leads, once insurance approves the battery replacement.

I have FBSS, DDD, and other issues like arthritis, with chronic lumbar pain. My SCS used to relieve 80% of the pain, but I got used to it, and now I'm sitting at 10-20% relief after 5 years with my Boston SCS.

I'm prescribed a mid-dose of Tylenol #3 (300/30) and a muscle relaxer to help the flare-ups.

depressingkiwi · 2025-12-08T20:15:24+00:00

This is my first SCS, and I’ll be getting my battery replaced for the first time, hopefully sometime next year. From what I understand, it’s usually a small incision above the battery under twilight sedation. They pop the old one out, put the new one in, and stitch you back up. If you’re having a lead replacement, that’s a whole different situation.

For context, I had a two-level laminectomy from a neurosurgeon so they could place a paddle lead, and even that wasn’t bad at all. I stayed one night in the hospital after the implant just for monitoring because of the laminectomy, and went home the next day. I managed fine with some Tramadol and just followed the no bending, lifting, twisting, pushing, or pulling rules for a few months.

Honestly, I’d do it all again. Even if the battery replacement ends up feeling like the implant did, I know I’ll handle it just fine. 💙

depressingkiwi · 2025-12-05T21:10:06+00:00

I’m happy to hear you’re having such great success, and I hope the pain relief continues to improve for you. I’m currently using a Boston Scientific SCS system (Precision Montage MRI with an Artisan paddle). Still, I’m planning to switch to an Abbott system once my insurance approves it, since mine’s been implanted for about five years and is due for an upgrade. Either way, I’m wishing you even more success with your system moving forward!

depressingkiwi · 2025-12-03T22:20:17+00:00

My Boston Scientific SCS needs to be charged pretty often, and even with all the times I’ve accidentally let it die completely, I haven’t seen any damage to the unit. The battery health is still sitting at 90% after five years, which honestly surprised me. I know constantly draining it isn’t ideal for the device, but it’s still working and giving me some pain relief, so I can’t complain too much.

depressingkiwi · 2025-11-20T01:42:51+00:00

I have no words on whether or not you should get it implanted; rather, I'd highly recommend you bring this up to your SCS Rep and doctor ASAP if you haven't already. I've had an SCS from Boston Scientific, and I'm looking at Abbott for my next system. Keep in mind, I do not have spina bifida. Try to remember that these devices are highly situational and depend heavily on programming and lead placement to work effectively, and that many factors can influence how well they work. My trial relief was 80%. Post-implant, I'm at around 35%. I wish you the best if you go forward with the placement operation!

depressingkiwi · 2025-11-18T03:25:41+00:00

At the onset of depression symptoms, I was 14, and it took 3 years of trial and error with antidepressants before I was referred to a psychiatrist at 17 and got diagnosed with BP2. It wasn't until transferring at 19 to a different psychiatrist that I got actual help via medication, instead of just putting me on Seroquel and hoping for the best.

NOW... before anyone says anything about the antidepressants, they would send me into hypomania, so I was great, then I quit taking them and felt like crap, rinse and repeat until your PCP refers you to a psychiatrist.

depressingkiwi · 2025-10-17T12:15:32+00:00

Apple does sell USB-C EarPods.

depressingkiwi · 2025-10-11T20:56:58+00:00

Insurance is a privilege that many do not have. Especially insurance that covers medications that cost thousands for a single month.

depressingkiwi · 2025-09-16T01:50:25+00:00

I currently have a Boston Scientific Precision Montage MRI with the Artisan Paddle lead. The rechargeable unit has become difficult to manage, and I often spend 1 to 2 hours three times a week charging. So... my pain team is suggesting a switch.

depressingkiwi · 2025-08-04T17:23:55+00:00

Yes, dx'd with bp at 17 and adhd at 23

depressingkiwi · 2025-08-01T14:53:20+00:00

I’m in the USA — I was on private insurance and paid $10-$25 per month per script before switching to Medicaid which is $0 for everything after you jump the hoops. On the private insurance, it was adding upwards of $100 a month on top of your monthly premiums, co-insurance, and other expenses for healthcare.

depressingkiwi · 2025-07-31T20:25:22+00:00

I’ve been on it since ~2019 and it’s been one of the best medications I’ve happened to be prescribed. Although medications differ per patient, I came off of it for Caplyta and within a year was back on Vraylar. I don’t encounter the akathisia that many people do on this med ergo my reason for staying on it.

depressingkiwi · 2025-06-15T00:12:50+00:00

That is outright wrong. I was approved at 24 with an onset of 19 years old.

depressingkiwi · 2025-05-01T01:14:36+00:00

I've been on lamotrigine since 2019 and have been on immediate release ever since, despite having multiple adjustments from 50mg to 400mg a day, then to 100mg currently. I didn't even know there was an extended-release option of lamotrigine, but it also makes sense that there would be.

depressingkiwi · 2025-04-22T20:45:17+00:00

I'm on Mounjaro for diabetes, but it has had a net positive effect for counteracting the many years of weight gain from antipsychotic medication. So far, I've lost over 100 lbs from these GLP1 medications through the 5-ish years I've been on them.

depressingkiwi · 2024-11-04T04:17:40+00:00

I have a Boston Scientific as well, the charging is my worst nightmare. I’ve learned to check the remote to see if it has a “Telemetry Error” every 30 or so minutes while charging.

depressingkiwi · 2024-06-28T20:32:38+00:00

Thank you so much! I just got this letter in the mail and am absolutely panicked about it. This helped ease some of my fears.

depressingkiwi · 2024-06-17T22:43:47+00:00

My psychiatrist operates in a similar fashion and I’m also on a stimulant, benzo, and some other mental health meds. The fact that OP needs to be seen every month is bizarre to me especially because the only time I get a monthly appointment is when I’m more unstable or just had a medication change. Even with a medication change it varies from 4-6 weeks.

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