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    living better through chemistry

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  1. Hey @ananke. Try to breathe. The first 6 months at a new job is always stressful - especially the first few weeks. If there's a training schedule, would you be able to miss therapy for the first few weeks to be able to do the standard training? With the understanding that once you've completed that you will work a modified schedule most of the time. It's fair to ask for accommodating hours - and fair for them to say that there are some instances they need your flexibility too, right? Maybe during this intro period you could do phone sessions with your Tdoc? Do you have to tell your employer your diagnosis? Could you just say you have a mental illness and need regular therapy? I know there's a lot of stigma about PDs and I don't want you to get hurt by it. If you've already told them though, try to have some confidence that you'll be treated fairly. There is a growing understanding of mental illness in general. You are competent, and dedicated to your work. You're learning - so of course you're going to make some mistakes. No one expects you to be perfect right away. I'm sorry it's so hard. Hang in there and keep us updated.
  2. Try this page https://www.humana.com/finder/medical?pageId=a769eecca99f4452b6cec43c01066f6f Though it will be best to verify with your provider - oddly, these databases aren't updated as frequently as you'd think, so if the doc recently came on/off the insurance, it may be incorrect.
  3. Can you just download the full drug list? Scroll further down that page I linked to, and choose plan year (2019), plan type (Medicare Advantage - right?), and your state... should let you download a pdf with the full drug list. Open the pdf in adobe or another pdf reader and use ctrl+f to find "vyvanse" and "viibryd" (or scroll down to the V's manually).
  4. I recently got a new job, which caused a change in my employer-sponsored health insurance. My previous employer offered a plan through United Healthcare (with Optumrx pharmacy benefits). I found it was very, very had to find MH providers who would accept United. I was told that United Behavioral Health (the MH arm of UHC) has some of the lowest reimbursement rates and some of the highest denials, so it is time consuming for providers to submit (and re-submit/appeal) claims and then the payment is a pittance. I now have a Humana plan. My current employer is not based in my state (I work at a small satellite office), but they chose Humana because of the size of its network across the country. I believe they said the only counties in the whole country that didn't have Humana providers were counties that didn't have any providers. I can tell you - my Tdoc (who took UHC when I started seeing her, but stopped about 6 months later) takes Humana. When she stopped accepting UHC, Tdoc allowed me to pay her out of pocket at the same rate that she would have gotten from UHC (we decided not to file out-of-network claims due to my high OON deductible). She's got a PsyD with 25+ years experience, and the rate from UHC was $69/53+ minute session. Now, with Humana, between my co-pay and the share from Humana, she gets $114/53+ minute session. If you're comparing plans though, another thing I recommend is to find out what prescription plan/formulary you'd be getting, and checking to see if all your meds are covered. I didn't have issues getting meds covered when I was under UHC - but starting in 2019, Humana dropped coverage of a med I was taking that they'd previously covered (Savella). They also don't cover my current anti-depressant (Fetzima), though my Pdoc thinks if it works it's worth making an appeal to Humana to have them cover it (trying it now on samples). Here's a page from Humana's site where you can see what meds are covered under their medicare plan.
  5. My pharmacy does not write the manufacturer on the bottle, but it does include a description of the pills in the bottle - color, shape, and any writing on them. You can look up the pills to learn the manufacturer, all that stuff is unique. I haven't had issues with different generic brands, but I do verify the pills in the bottle match what the bottle says they should be anytime I get a new script or the manufacturer changes.
  6. I had Optumrx for several years, through my last employer. I didn't have many issues with them - but I also didn't use their mail-order service. The issues I ran into were all specific to the Walgreens I'd been working with. What's going on?
  7. @looking for answers just remember that (as always) this stuff is subjective. Personally, I take 300mg of IR Seroquel for sleep. It makes a noticeable difference over 200 or 250mg.
  8. Thanks for the suggestions everyone. @dancesintherain - I had used Zocdocs a year or two ago and forgot about it. Thanks for the reminder! I am more than open to seeing an NP or a PA. In fact, the provider I really liked at my current GP's office was a NP. I've had much better care from NPs and PAs than from MDs. Perhaps it's due to the different background/approach?
  9. Does anyone have tips on how to find a good GP? Who gets MI and won't talk down to me because of it? Physically, I am doing better than mentally. I do take daily and rescue meds for asthma. My GP's office is quite far away from where I live and work now. And the provider there that I liked moved away years ago... I have stayed with the practice only because I haven't really needed them. They've fumbled the few things I've sought their care for in the last few years. Now they're jerking my pharmacy around. It's time to move on. Tdoc and Pdoc don't have recommendations. I don't have friends. I don't know who else to ask.
  10. I am somewhat skeptical of the utility of an inpatient visit for a depressive episode if either a severe med reaction and/or safety are not an issue. The fact is that unlike mania or psychosis, meds for ending severe depressive episodes take weeks to kick in. Add in the cost and discomfort of an IP stay, and it seems... less than useful. That said, if it would make you more comfortable to feel like something was being done, to have some time off to regroup, etc. then go for it!
  11. I usually see my Tdoc in person, but we have done a video session when our schedules didn't mesh. I found it hard - I couldn't feel her presence in the same way. I had trouble "letting go". I hate seeing a new Tdoc, but I think I would struggle to make a connection with someone I saw exclusively by video. That said, I wouldn't rule it out. It's just not my first choice.
  12. That's why I come here: it helps me feel less isolated.
  13. Apologies, Ananke - I knew that but forgot. As another non-USian, I do hate when assumptions are made that everyone lives in the US (granted, currently I am living in the US). I'm sure you know though, that you do have similar rights under the Equality Act 2010 (unless you're in Northern Ireland) and the UN Convention on disability rights. This guidance from the Equality and Human Rights Commission says that it is a reasonable accommodation for your employer to allow you to have time off for treatment. Mind gives some guidance too, on when, how and why to tell your employer about your disability. It's an anxiety provoking thing, for sure. I try to remember that our supervisors and managers are people too. I try to emphasize that I'm ill, and many people can relate to that. Combine that with demonstration of your work ethic and hopefully they'll be able to work with you rather than against you.
  14. Geek

    Questions Thread

    None - the handful of stores I go to with those kinds of things just look me up in their database by my name or phone number. 90*F and sunny or 75*F with clouds and possibly light rain?
  15. I leave work to see my Tdoc on Mondays at 1.30 (then go back and finish out the day). I've been doing this for several years, though I've only been with my current employer since July. After the first week at the new job, I told my supervisor that I have a weekly medical appointment that I need to go to, but I want to make up the time. I am flexible about mandatory meetings, etc. They're fine with it and I've only had a couple times where I've had to reschedule due to a work commitment. I have a job where I am not dealing with the public, so there can be more flexibility to my hours than there might be for other positions. Due to rules around ADA and medical disabilities, most (smart) companies will be reluctant to push hard about if it's necessary, what your dx is, what kind of medical appointment it is, etc. They may request a letter from your doctor saying it's necessary - you could ask your Tdoc, Pdoc or probably even your GP to write such a letter which, again, could be vague. I feel like a company would be more inclined to allow schedule flexibility for medical care than for a secondary job (especially because of not wanting to run afoul of ADA), but I don't know. Edited to add: I have never felt judged by my colleagues over the years. Most of the time they don't even notice my absence. If it needs to be mentioned for scheduling or something, I just say I've got a medical appointment but I'll be back. If they comment beyond that (which is rare), it's something like "oh, is everything okay?" I smile and say "oh yeah - just a routine thing, no biggie" and then ask a question about the work we're doing. I ran into an issue with my former employer, to whom I had disclosed my dx to for the purposes of justifying short-term disability and some other stuff. I worked there for almost 4 years. They ended up forcing me to disclose that I had missed a week of work because of being IP (I had a doctor's note from the hospital, which doesn't list dx or ward, just said I was sick and cleared to return to work on x date), and then writing me up for "abusing" flex hours "including with prior approval." Their actions were illegal and after they were informed of that they backed off. I ended up leaving the company 4 months later. There were a lot of reasons for that choice, but certainly the way they treated me about my dx was part of it. I'm really hoping I can avoid having to disclose my dx to my current company, though at some point it may become necessary if I need formal ADA accommodations.
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