It seems everyone, at sometime will need to fill a prescription of some type. Whether for your child's cold, your migraine headaches, or for your husband's thinning hair -- we all live with and by prescription medications. So much so that many are converted to OTC (over the counter) and no longer require a written prescription from the Doctor.
While we all use these medications occasionally or regularly, we all experience the same problems in getting them filled. First, no one can read them except for the Doctors and Pharmacists. Who's to say they're not just passing lurid jokes back and forth? It would seem they're worthless, anyway.
After that, finding a Pharmacy has become easier than finding a convenience store or gas station. There are several on every other corner, so that's not part of the problem. Those begin when you actually get up to the counter to request that your prescription be filled. Most Pharmacies are overwhelmed during particular hours: upon first opening, although this is usually only on Saturday's and Monday's, or following a holiday; next is between the hours of 10:30 am until 1:00 pm, due most in part to patients who've just seen their Doctor and received a new prescription or a newly written prescription order; then again, between 2:00 pm and 6:00 pm or later is extremely busy. Again, due to afternoon appointment patients, and those patients requesting refills that morning or the day before; The busiest days are Monday, Tuesday, Wednesday, some Thursdays, and always on Fridays. -- If you know or have a Pharmacy that is open on Saturdays, use that day, you'll save yourself a lot of time and frustrations.
Next, you'll need to present at pertinent insurance information, insurance I.D. card, plus your own personal identification, along with your date of birth, full address and telephone number. Now, don't relax just yet, the tough stuff is still to come. Two very important things, first. Different states have different rules regarding how long a prescription is accepted from the date on the prescription. So, if you aren't getting that prescription filled right away, be certain you know how long you can wait before you must fill the prescription or return to the Doctor for another one. Second, if you're concerned about the cost of your prescription, NOW is the time to ask the Pharmacist for an approximate pricing.
If for some unknown reason, your Doctor did not complete the prescription form correctly, well, just stop. Don't argue. It won't change anything. Take a deep breath and return immediately to your Doctor's office. I would even call ahead to alert them to the problem so they can write a correctly completed prescription by the time you arrive. Now, to be fair, the State and Government change the look and appearance of prescription pads regularly to decrease fraud. But, they also change the required information and where to put it on the form each time, also. So, take that few extra minutes while you're at the Doctor's office the first time, and read over every line and box of information required to make certain the Doctor didn't inadvertently miss a important requirement.
Once the prescription is deemed to have been completed properly, then you should expect a wait of at least 30 minutes, but more often 1 - 2 hours, for it to be filled. Consider using the Pharmacy at your local grocery or discount store that you frequent, that way you can do your shopping while you wait. Otherwise, if the wait is beyond 30 minutes, I would choose to run other errands and return at a later time.
Part of the delay is the Pharmacist generally has to contact the Doctor to verify the authenticity, the correct medication, dosage and frequency -- just to minimize fraud, again. They have found alot of patients change the number of pills, the number of refills, and sometimes the dosage or strength of the medications. Honesty is never just assumed, anymore. In fact, quite the opposite.
After that's verified, then they must verify your insurance coverage is valid and in effect, plus what medications are covered or not covered, and how much the insurance will pay toward each prescription medication. Some plans pay a flat rate for medications, while others have a tier-rate system. They pay so much for drugs from column A, a different amount for column B, different again for column C, and D, and so on. While others pay only for Generic medications, even when there is no Generic equivalent available. Some plans only discount a certain percentage off the cost of the medication, while others have an annual maximum they'll pay for all medications filled within the same calendar year. The manner that insurance companies pay towards prescription medications is as varied as the insurance companies, themselves. Even some plans within the same insurance company pay out benefits differently. Read you policy benefits or contact your insurance provider for full details as to how they calculate payment toward your prescription medications.
After all that, the Pharmacy may not have sufficient stock to fill every prescription right away. Most will offer to fill for less than the prescribed amount, temporarily, until they can restock the need medication. Of course, you'll need to return later to pick-up the remaining pills.
If you find a diligent Pharmacist, and most are, they usually try to shop around for the lowest price with their competitors, and will mostly match any lower price. If your Pharmacy doesn't offer this service, then you can call around to several drug stores and ask what their cash price is for your prescription. I would strongly advise calling Sam's Club and/or Costco, as they generally have the lowest prices. If you find a lower price, bring it to the attention of your Pharmacist. If they don't match the lower price, I'd look for a new Pharmacy.
Once all this extraneous stuff has been completed, then can your Pharmacy begin to fill your prescription. When completed, it is the Pharmacist's duty to offer you a consultation -- to discuss the medication, what it's for, whether it should be taken with food or not, and any possible side effects and so on. If you are taking any other medications, over the counter drugs, supplements, and/or vitamins, NOW is the time to have the Pharmacist check for possible drug interactions. These can be fatal. I strongly advise you NOT to wave off the Pharmacist's consultation. It could mean the difference between using the medication safely vs taking it incorrectly, leading to most side effects and possibly even death! Even if this is a drug you are familiar with, at least allow the Pharmacist to check for any drug interactions with your other medications. Also, always verify that you completely understand when to take the medication. Twice a day can mean several things: a) upon waking and at bedtime; b) between meals; c) a specified time, i.e., every 8 hours; or d) with meals; There are several ways to interpret twice a day, so ask the Pharmacist to clarify exactly when to take the medication, or if it makes any difference.
Finally, before you leave the Pharmacy counter, do two (2) things:
1) Count the number of pills in the bottle matches the number of pills prescribed on the bottle.
2) Verify that the pills inside the bottle are the correct medication.
Additionally, make certain that you receive all the bottles of medications prescribed and paid for. Once you get home, review all the literature from the Pharmacy about your medications, including all known side effects and what to do should you experience any of them.
Now, if you're they to pick-up a refilled prescription, well, the rules are a bit different. Most Doctors and insurance companies will only allow either 30 days or 90 days worth of medications, depending upon the specific drug. Which doesn't work out well for months with 31 days in them. Most insurance companies only allow you to request a refill no more than 25 days after your last prescription was filled. In some cases, this time is reduced to 72 hours before the 30th day after you last filled that prescription. For example, if I filled my prescription last month on the 15th, with the 25 day rule, I can begin to request refill on the 10th of the following month; with the 72 hour rule, I can begin to request on the 12th. Which appears to be sufficient time, except because last month was 31 days long, I'll completely run out on the 14th of the following month, so my 5 day grace period just became 4 days, and my 72 hours became 48 hours. Oh, and guess where the weekend falls? Bingo! So now, I've got no time and a very good chance of running out of my medications!
First, call in the refill the day before the 5 day grace or 72 hours. Next, contact your Doctor and explain that even though you are following the rules, you will run out if they don't approve a refill before the weekend. Then, keep call both the Pharmacy and the Doctor twice daily. You don't want to become a pest, just be persistent! If all else fails, ask if they will allow you enough pills to get you through until Monday. And finally, always make certain that the medication your Doctor calls into the Pharmacy to be refilled is the correct medication that you need filled!
This brings up a series of questions even I don't fully understand:
1. If I have a written prescription and the Pharmacy can call the Doctor, then why when I requesting a refill can they only send a fax to request an approval? For some strange Doctor/Pharmacist law, they can only communicate via fax with regards to refills. Who knew?
2. If the original prescription says to give me so many refills, then why are we doing any of this other stuff to begin with?
3. Why does the insurance company always get involved? Especially if they believe you want to get your prescription refilled one day early?
4. Why do Doctors post signs in their offices that state, "All refill requests will take a minimum of 72 hours to process." Do they mean 72 business hours or just 3 working days? I'm confused and I know the answer.
5. Why do I always have to remind everyone else, (the Pharmacy, the Doctor, and the insurance company) that a 30 day supply doesn't last as long during a 31 day month? Am I the only person who understands the math?
6. When it's down to the final few hours before I spend my weekend in pain, and the Doctor's office swears they sent a faxed approval to the Pharmacy hours ago, while at the very same time the Pharmacy swears they haven't received anything from the Doctor's office? How does passing the buck help? It doesn't. I don't care who did or didn't do what, I just want my refill to be approved and filled so I can come and pick it up!
7. Why do these rules exist? I can't go to visit my elderly parents for more than 3-1/2 weeks because I can't get more than 30 days supply of my medications. Not 31, 40, 45 , or 60, just 30 days exactly!
8. If you take more than one medication, this creates it's own ripple effect: drug A has to be filled on the 10th, drug B on the 12th, C on the 17th, D on the 23rd , and so on. That creates numerous phone calls each month, plus alot of wasted time with at least 3-5 separate trips to the Pharmacy, if all works out well. Which rarely happens. Usually I make one trip for each prescription. I once tried to ask my Doctor to write a partial prescription just to get all my medications to refill at the same time. You would have thought I was holding him at gunpoint!
The harsh reality is, there is no easy way to deal with getting your prescriptions. I've tried the Pharmacies with the automatic refills. It doesn't work any better than calling them in yourself, because, again, they fill based on the 30 day month, while 50% of our months during a calendar year are 31 days long. So, I either suffer through for a few days, or I keep banging my head against that stone wall. Either way, I still end up with one heck of a headache!
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