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What Is Non Medical Switching?

Finding a treatment that works for a mental health condition is difficult. The process of finding a therapist or medication takes a long time, and you may have to switch several times before you find the combination of treatments that work for you. What if you find a medication that works for you, but then your insurance company says that you can’t buy it anymore unless you change your insurance plan? What if they increase its price so much that it becomes unaffordable?

You might not know it, but this sort of thing happens enough to have a name. That name is “nonmedical switching”. It occurs when an insurance company changes the terms of a contract or cost of a medication for a stable patient (meaning you have found a treatment that controls your symptoms). It could be that your medication is now on a different “tier” of their health plans, meaning you would need to buy a more expensive plan to receive it. Sometimes they stop covering your medication entirely, or they increase the co-pay. Another form is when they lower the maximum coverage amount for a prescription medication, limiting how much you can receive through your plan. No matter how it looks, nonmedical switching leaves you without your medication.

Thankfully, many organizations are interested in addressing this problem to prevent it from happening to more patients. One campaign, called Keep my Rx, is trying to gather support to speak out against this harmful practice. They have several helpful infographics, like this one, that demonstrate what nonmedical switching is, and another, that contrasts it from common step therapy procedures. Living with a mental health condition and finding a medication that works for you should not be more complicated than it already is. Your health should not be compromised for an insurance company’s bottom line.

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