Coverage for Abilify

I have depression and none of the drugs have been working.  My doctor now wants to try me on Abilify, along with my latest anti-depressant.  He has mentioned that he’s worried my plan will not pay for it.  Why would he be worried about that?  Now I’m worried!

Looking Up

Dear Looking Up,

Nearly all health plans cover prescription drugs that are approved by the FDA.  It’s unlikely that your plan flat out does not cover Abilify.  The drug that you want, however, is an expensive, anti-psychotic medication that should only be used in certain circumstances. The plan may require you to get a pre-approval, before they will pay for it. The plan may also ask that your doctor verify every so often (say, every 90 days) that you still need the drug.  So, your doctor may be concerned that the plan will turn down your request.

If your plan will not pay for it and your doctor feels strongly that you would benefit from it, you can purchase it yourself or apply to the drug maker for a discount. There is no generic of Abilify, so there is not a cheaper version of it from another maker.

I hope that you will find a treatment that works for you!

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.