Will Health Insurance Cover Antidepressants?
Many health insurance plans cover antidepressants but the exact amount of coverage depends on your individual plan. Although antidepressant use is not uncommon, your individual insurance plan may have stringent regulations when it comes to paying for them based on the type of medication and condition being treated.
Reading the fine print and following the insurance plan’s requirements are the most effective ways to ensure you receive the coverage your plan offers, or find out if it provides any antidepressant coverage at all. Two places to check for antidepressant coverage include the prescription drug and behavioral health categories.
What is Behavioral Health?
The behavioral health portion of your health insurance plans typically outlines the kind of coverage you have for mental health issues. This section may also include guidelines or suggestions when it comes to selecting treatment for depression and mental health issues as well as the requirements you must follow to obtain it under your plan.
In addition to coverage for medications, some health plans may offer coverage for therapy sessions or a certain number of visits to a mental health professional. Plans may require referrals from your primary care physician or other healthcare professional to be eligible for coverage for such visits. It may also require that your antidepressant prescription come from a specialist other than your primary care physician.
Can Antidepressants Help?
Recurring or chronic symptoms of depression may be an indication to pay a visit to a mental health professional that can better assess if antidepressants may be helpful for your condition. Going through a major trauma or life change may make people sad as they process and deal with the information; a state of mind that is not necessarily the same as a clinical diagnosis of depression.
A diagnosis of depression may instead come from extended periods of suffering while exhibiting an array of symptoms linked to the condition. Mayo Clinic says symptoms of depression include loss of energy or interest in things that used to interest you, changes in appetite and sleeping habits, feelings of sadness, and frustration at the smallest things.
You may also be easily irritated, prone to violent or angry outbursts, and break into a crying jag for no apparent reason. Depression can make it tough to concentrate or even go through a day without thinking about death or entertaining thoughts of suicide.
Contrary to what some may believe, antidepressants do not automatically put you in a good mood or serve as a type of upper. They are not downers or sedatives, either, and are not designed to leave you in a zombie state. They are instead meant to balance brain chemicals, according to The Rost K. Depression Tool Kit for Primary Care.
Antidepressants are not addictive or habit forming and may take some time before the effects are felt. Your doctor may start you on a low dose of a particular medication and increase the dose if the drug seems to be helping you. Once the ideal level of medication is established, it may take about three to six weeks for you to start feeling like you used to before the depression kicked in.
It may also take some time to even find a drug that will help you. Antidepressants come in many different varieties and one that works wonderfully for one person does not necessarily work at all for someone else. You may also experience some side effects, based on the type of medication you are taking and how your body reacts to it.
What Side Effects Are Most Common?
Because there are so many types of antidepressants on the market and each person may react differently, Mayo Clinic notes the wide variety of side effects that may crop up. They may include a decrease in sex drive and an increase in weight gain. Other medications may react with your body to cause digestive issues, nausea, diarrhea, vomiting, headaches, and trouble sleeping. Still others may induce dry mouth, rapid heartbeat, increased sweating, and constipation. You may react with restlessness, confusion, or thoughts of suicide.
Not every antidepressant is meant for every person, and severe side effects such as seizures may also be on the table. On the other hand, you may not experience any side effects whatsoever. It all depends upon your body’s reaction to the drug.
How Much Does Anti-Depression Medication Cost?
Your out-of-pocket expense for antidepressants again depends on the type of coverage offered under your specific plan as well as the type of medication you’re prescribed. Newer antidepressants may only have the brand name available, which may cost you more, while those that have been around awhile may have a less expensive, generic version available.
If your antidepressants are covered under your plan’s prescription benefits, you may be able to purchase a generic antidepressant for the same price you may pay for other prescription medications. Health insurance companies may also have a list of antidepressants and other drugs they do cover, which you can review to see if your particular type is on the list.