Why Is It So Hard to Get My Prescriptions Refilled?
I've been on prescription medications for 16 years now, and it's amazing how many different things have made it difficult to get my refills.
Why can't I get my migraine medications refilled?
It's particularly confounding because I've never been on controlled substances for my illness, just non-opioid medications like beta-blockers, tricyclic antidepressants, or anticonvulsants. If I run out of pills, I'll go into painful withdrawal symptoms such as nausea, body aches, and an even more painful headache than normal. Problems getting refills are one of the most stressful things I deal with because it causes low-level anxiety that follows me throughout the day until the issue has been resolved. Let me count all the reasons why this has happened.
Did the pharmacy run out?
Like any store, sometimes a pharmacy runs out of stock, and they have to wait for delivery before filling the prescription.
What can you or the pharmacy do?
They'll either give you a partial fill of the medication in the meantime or direct you to another pharmacy in the same chain that has it in stock.
Did I wait until the last minute?
I try to refill my prescriptions at least a week before I'll run out of pills, but I don't always stay on top of that. In the best-case scenario, the pharmacy can refill the drug immediately, and you'll avoid withdrawal. In the worst-case scenario, you discover you're out of authorized refills on a Friday afternoon when your doctor is gone for the week, and you foolishly believe it will be fine to wait until Monday to get a refill approved. Don't do this!
What can you or the pharmacy do?
Do whatever you have to do to get that prescription filled ASAP! Beg. Make uncomfortable phone calls. See if the pharmacy will spot you three days of pills until the refill is authorized. Get it done! Withdrawal sucks…and aches and barfs.
Did I try to refill too soon?
My insurance company won't allow me to purchase a refill until 30 days after the last refill. This can be challenging if you know you're going to be traveling for a period of time and need to stock up on medication.
What can you do?
You can usually get the prescription transferred to another pharmacy in whatever area you'll be visiting and then transfer it back when you get home.
Did I move?
I moved to a different state a year and a half ago, and the first appointment I could get with a headache specialist was three months out. During that time, I had to beg my old doctor to authorize a refill every month because it turns out he was ethical and didn't want to endlessly authorize refills for a patient he hadn't seen in months. Damn him!
What can you and your old doctor do?
You'll have to keep nagging the old doctor for refills until you get in with the new one. Let the old doctor know the name and appointment time of the new doctor so they know you're not playing them. I was so relieved when the new doctor authorized six refills that you would have thought I'd taken a muscle relaxant.
Why won't my insurance company pay?
In 2012, I entered a high-risk insurance pool for my state, but to get a pre-existing condition covered, I had to prove another insurance plan had covered me for the past 18 months. I'd sent proof I'd been on COBRA for that amount of time, so I thought I'd fulfilled that requirement. Wrong! Three weeks after I sent my prescriptions to the mail-in pharmacy, they sent me a letter saying they couldn't fill the prescriptions because they were for my pre-existing condition. It turns out my insurance company required that I get a certificate of credible coverage from my old insurer, even though the COBRA documentation proved the same thing the certificate would. Bureaucracy!
What can you or your doctor do?
I had to scramble and ask my doctor to send prescriptions to my local pharmacy. Then I had to shell out several hundred dollars to get the meds before all the paperwork issues were worked out. I was able to file a claim later to get the money back, but the whole ordeal was a pain in the ass in addition to a pain in my head.
Does my insurance wants a 30-day prescription?
My old insurance company required that you get a 30-day prescription for a medication the first time it was prescribed. After that, you could then get a 90-day prescription filled. This is a minor annoyance unless the medication you need is only packaged in 90-day increments, like some forms of birth control.
What can you do?
Call customer service and explain the situation. Accept that this might require a lot of time on the phone, but you'll probably get an override authorization.
Did I change doctors?
For various reasons, I switched doctors twice in the past 18 months. Both times my new doctor sent prescriptions for my meds to my pharmacy, but the pharmacy kept trying to refill my old doctor's prescriptions for some reason (probably having to do with computer software). This was trouble because that doctor was not going to authorize new refills when they ran out. Even stranger, they managed to fill one medication with my new doctor four times before suddenly switching it back to the old doctor. I thought this was a fluke, but when I changed doctors again, later on, they filled my medication with the old doctor's name even though I'd called and specifically asked them to use my new doctor's prescriptions.
What can you do?
It was enough of a mess that I'm going to transfer the prescriptions to a pharmacy I've never used before, so there's absolutely no chance of them filling the medications under the wrong doctor's name again.
Did my doctor disappear?
I didn't connect well with the first primary care physician I saw after I moved, so when the time came for my annual physical, I switched to a different doctor. I sure was glad I had when I received a letter a month later saying my old doctor was no longer with his practice. There was no explanation given, and the scheduler I called at the office didn't know why the doctor had left either. Given how sudden his exit was and the fact that no one would talk about what happened, I can't imagine there was a positive explanation for it. I was glad I'd already switched doctors. Otherwise, I would have probably had a panic attack trying to find someone to renew my prescriptions in time.
What can you do?
Go with your gut and switch doctors if it doesn't feel right. Otherwise, see if one of the other doctors at the practice will renew your meds.
Have you run into any other obstacles trying to get your prescriptions filled? What were the consequences of the challenges?
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