As if life isn’t stressful enough, sometimes getting your medications can feel like a part-time job. Here are some tips on how to tackle roadblocks to getting your meds promptly!
In an ideal world, your doctor prescribes the medication (often electronically or over the phone) the pharmacy fills it and texts/calls you to pick it up or delivers it.
(If you do not have text alerts on, consider setting them up)
In reality, the process can be more complicated.
If it’s been a few hours and you haven’t heard anything, you can call the pharmacy to inquire. Sometimes it is ready for pickup and there just wasn't an alert. Other times it requires more digging.
~If you are told “we don’t have anything for you” or “we didn’t get a prescription” you can ask the pharmacy more questions~
# Do you have the prescription for XYZ medication in your system?
- If not, perhaps there was an error in the pharmacy/provider software or the doctor
sent to a different pharmacy you use
- Sometimes the prescription or a refill is in the system and they are waiting for your
request to dispense it
# Is the medication out of stock?
- Sometimes the pharmacy physically doesn’t have those pills in their store
- Can you order it? (sometimes can take a few days)
- Is it on backorder? (may take weeks/months) and may be related to national
shortage or supply chain/manufacturer issue
- If it is not a controlled substance, most pharmacies can try to find a local branch that
has it in stock and ask them to fill it
- If it is a controlled substance, a new prescription will need to be sent to a different
pharmacy, contact your doctor and provide a different pharmacy store near you for a
new prescription to be sent
# Is it an insurance issue? (what is the insurance rejection message)
- Sometimes the insurance company requires a prior authorization (clinical information
about your case including diagnosis, past med trials, etc) to cover a medication.
-you can ask if they have informed the doctor of this yet (many pharmacies initiate
this and fax/call the doctor without prompting)
- Most insurance companies have a preferred pharmacy they work with. If you're using
a non preferred pharmacy, they may not cover the prescriptions.
(you can call your insurance company to find out their particular pharmacy and ask
your doctor to send to it)
- If you are trying to fill the medication early, the insurance plan may not cover as it is
too early to get a new supply
(Controlled substances are highly regulated and the pharmacy and DEA rules prevent
early dispensation of these types of medications)
*Please note, this is for informational purposes and does not constitute medical advice/recommendation. Every insurance and pharmacy plan is different and doctors and states have specific regulations and rules.