ladyamalthea

So, I went to the doctor this morning. She wrote me a prescription for Wellbutrin. I was all happy, I thought I was going to get to start trying to turn things around. And then the pharmacist tells me that my insurance requires something called a preauthorization for that medicine. Why??? No one seems to know... but she did tell me that even the doctor calling to get the authorization does not mean the insurance will issue it.

Anyone have an understanding about why my insurance might do this?

justanothrdrunk

There could be a few reasons:

1. Your plan doesn't cover any sort of smoking cessation. Wellbutrin is also used to help people quit smoking. Your insurance co. may be attempting to verify that it's being prescribed for depression and not to quit smoking.

2. Your plan uses some sort of "formulary." A forumulary is a list of the plan's preferred drugs. It's possible wellbutrin isn't on the formulary for your plan and you may have to try some alternatives.

3. Your plan has provisions regarding treatment for mental health care. This one is a real wild card. There could be all sorts of hoops/red tape you need to do before getting any sort of treatment for mental health disorders.

Obtain a copy of your Summary Plan Description and read it. You may either have to contact your insurance co. or your employer depending on if you have an employer sponsored plan and how that plan is funded.

Or, call your insurance company and ask them about coverage for wellbutrin. They should be able to give you all the details. Still, having a copy of your plan booklet (summary plan description) is a good idea. The insurance company or your employer is required by law (both state and federal) to provide you with a copy upon request.

ladyamalthea

Thanks so much, Justanothrdrunk.

Okay... I'm looking online, this is what it says:

"Your plan provides coverage for this medication for uses other than smoking cessation therapy. This medication is covered."

So, then, that means that #1 in your response must hold true???

I had forgotten that I could look that up online. I never would have thought about that, as I've never smoked a cigarette (or anything else) in my life.

historyteach

It's sold under the trade name Zyban for smoke cessation. But, many docs will say depression, and people will go for it, in order to get the Wellbutrin for the smoke cessation. It's the exact same medication.
And it doesn't work that great, so it's not worth it to me!
Gave me panic attacks!
Chantix is a much better choice for quitting smoking, *in my opinion.*

Good luck, lady. It's a good drug for depression and weight concerns.

Shalom!

respektingme

Wellbutrin put me on a real heightened state of alert. I was very irritable and lost all patience with everyone around me. I know it works for some, just thought I'd tell you my experience for reference.

ladyamalthea

Ok, now I'm getting annoyed...

The doctor's office closed 15 minutes ago, and I have yet to hear back about the prescription. I was really looking forward to getting this taken care of... and instead, I've basically wasted the day waiting to be told that I can go pick up my prescription...

ugh!

historyteach

The Serenity Prayer, Lady...

Shalom!