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Why is it so hard to get my prescriptions refilled? Let me count the ways.

Why Is It So Hard to Get My Prescriptions Refilled? Problems and Solutions.

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. 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 problem has been resolved. Let me count all the reasons why this has happened.

The pharmacy ran out of that medication

Like any store, sometimes a pharmacy runs out of stock and they have to wait for a delivery before filling the prescription.

Solution: 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.

I waited until the last minute and there weren’t any authorized refills left

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 is able to 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!

Solution: 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 gets authorized. Get it done! Withdrawal sucks…and aches and barfs.

I tried 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 travelling for a period of time and need to stock up on medication.

Solution: 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.

I moved and couldn’t get a new doctor right away

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!

Solution: 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.

My insurance company wouldn’t pay because of paperwork issues

Back in 2012 I entered a high-risk insurance pool for my state, but in order to get a pre-existing condition covered I had to prove I’d been covered by another insurance plan 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!

Solution: 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.

My insurance company wanted me to get a 30-day prescription that didn’t exist

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.

Solution: 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.

I changed doctors and the pharmacy kept filling the old doctor’s prescription

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 for some reason (probably having to do with computer software) the pharmacy kept trying to refill my old doctor’s prescriptions. 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 switched 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.

Solution: 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.

My doctor disappeared with no explanation

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.

Solution: 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?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • susghost017
    2 years ago

    My problem with refilling prescriptions is my neurologist. She never responds to refill requests in a timely manner and if it is getting close to a scheduled appointment she won’t refill any prescription, regardless of the medication, until the office visit is completed. Withdrawal has been my fear and companion more times than is fair or reasonable.

  • Katyb
    2 years ago

    I only get 9 pills covered by insurance per month like everyone else here. My doctor gave me a script for 30 per month and I go to a large pharmacy where they have a program for people without insurance. I have insurance. I get this particular drug as if I did NOT have insurance, though. I pay $32.00 for 30 pills. If I need one every day, then I have it. Just knowing I have access to my abortive medication lessens the amount of stress-induced migraines! When I was stuck years ago with 9/month I was such a wreck. My doctor would give me samples to hold me over. Then, a really nice pharmacist suggested I go on the “cash payment” program and I can get what I want. Now, this does not apply to controlled substances. It’s a life-saver for me!

  • Joleen1966
    2 years ago

    So, I was recently put back on Imitrex pills. The first time over 20 yrs ago it didn’t work for me. It does help some and I’m so excited to have found something to relieve the chronic migraine. I was given a RX for 9 pills. I thought that was an odd amount but figured they just want to make sure it works before giving me a full month’s worth. I went right through the 9 pills in a seek. Called for a refill and the Dr. approved it. Got the run around from the pharmacy. Finally got through to a human and they checked into it for me…….. insurance only covers 9 pills per 30 days. How ridiculous is this? It’s not a narcotic. It actually helps some…. If I was on state aid would it be filled? so frustrating!

  • Joanna Bodner moderator
    2 years ago

    It is so frustrating to hear this! I am so sorry…9 pills seems to be the “magic” number insurance companies are authorizing. You are absolutely not alone in this.

  • dado
    2 years ago

    I’m always amazed at the lack of compassion for migraine sufferers, especially at the pharmacy. My anxiety level rises every time I’m close to running out of any of my medications. It’s almost like how dare you have an excessive amount of migraines in one month
    I want my fears addressed not passed along until I’m in critical meltdown stage.!

  • cally826
    2 years ago

    I agree, they act like they’re just headaches not migraines. I start getting tense when I know I have to get more just because of the pharmacy. They don’t make it easy.

  • cally826
    2 years ago

    I should say after almost 25 yrs I switched from a chain to a local pharmacy, that was more than a year ago. I should have done it sooner. I had to go back 2 or 3 times to pick up my meds from the chain (CVS) even tho they were automatic refill. The reg pharmacist retired 5 yrs ago and its gone downhill from there. It wasn’t just me, they didn’t care about anyone. The local pharmacy has got to know me and will bend over backwards to help. If I have to be gone at the time my meds should be refilled they will mail it, they are happy to deliver at no charge. The have 2 shops in my city and are wonderful! So I know how much trouble we have and how we are treated~ you might check out your local pharmacies in your city and get some respect!

  • cturner
    2 years ago

    Have experienced many of these issues especially the “step therapy” attitude.
    have been with Kaiser for 25 years now and have a great Dr. but also because of the “opioid crisis”! I have to be tested and ok’d every 6 months.
    When my Dr. goes on vacation it can be a nightmare to get my meds refilled.
    I take T3 and Butabutal for my migraines and drink a lot of water, which can raise issues on the u/a test. The water was recommended by the neurologist! I have tried many drugs for my migraines, a lot of which caused severe side effects including a memory loss when driving!
    Dr.’s are now so paranoid to prescribe many meds that those who have a legitimate need will have increasing problems getting these refilled as time goes on or a new “crisis” takes over the news. Remember the “crack” crisis or the meth crisis?
    Now you don’t hear of these hardly ever anymore. Our state has legalized pot and now certain Dr.’s are prescribing it for migraines with no scientific research. It might help???
    Come on really? Not a thing I am willing to try.

  • Marian Andrews
    2 years ago

    I received a message from my doctor’s office saying that my PCP would no longer be in the office as of March 16th and I could choose another doctor, but none of the other doctors use narcotics to treat migraine headaches and I am taking morphine injections once a month. Now I have to find a new doctor and the old one did not give me any refills on my other my medications, either.

  • 1vrd26l
    2 years ago

    I keep running into the issue of my insurance company removing coverage of the medications I’m taking. Or they’ll decide I need “step therapy,” meaning try all the drugs you’ve tried before and then we’ll think about covering this one, but only for a limited amount of time. My doctor has to constantly submit prior authorizations to get my meds approved for treatment. Thank goodness she’s savvy, and an excellent headache specialist! However, there’s nothing she can do when they remove the drug from their formulary completely. It’s so frustrating to get a combo that works, then have insurance decide they no longer want to fork out the money for what’s best for me. “Try generic NSAID” was my most recent recommendation from Dr. Insurance. Next they’ll be recommending positive thinking and a cold banana peel.

  • marycr8on
    2 years ago

    I’m going through that right now with a medication from my gastrologist. This is a medication I have taken in the past and it isn’t a narcotic. The doctor called it in and the pharmacy called to tell me it hadn’t been approved but to wait a couple of days because it sometimes takes the insurance companies several days to go through the approval process. A week after the prescription was sent in, the pharmacy called to say it still hadn’t heard from the insurance company. So I called the doctor’s office and the insurance to get to the bottom of it. It turns out that the original approval had run out at the beginning of the month and they needed the doctor to send more information to re-approve it. All fine and well, aside from the fact that they had not informed ANYONE about that! So in the end, it will take about 2 weeks to get this prescription filled…

    I avoid a couple of your problems by using the pharmacy Target, so I can easily have prescriptions filled wherever there is a Target. I also have all prescriptions on an automatic refill so I don’t run out or run into the problem with the pharmacy not having it in their inventory. I have had a few medications that I no longer take not removed from the auto-refill, but the pharmacy always sends me a text when anything is filled so I can reject it, if I don’t take it anymore and they eventually remove it from the refill.

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