The insurance company is concerned that you’ll get three months worth of drugs and then switch carriers so they have paid for two extra months of drugs that they shouldn’t have or something. Seems kind of ticky tack to me and it should all even out in the end but once one insurance company does it, they all have to do so.
They’re also concerned that they’ll issue you 3 months of some pricey drug and your doc will switch it to another med after about 8 days, and they can’t take the pills back, and you end up dumping $600 worth of meds down the crapper.
I feel your pain. I hate dealing with situations with the doc’s office and pharmacy.
I always call and ask for the meds I need for my endometriosis about a week ahead of time, as I have to call every single month for the refill, like the OP.
Three times, they’ve called it into the wrong pharmacy, even though I provided them with the pharmacy’s phone number. Twice it hasn’t been called in, period, and the rest of the time the pharmacy was jerking me around.
I called the pharmacy after a week of trying to get this prescription filled, and was asked to please hold. I held for over 30 minutes. When the person got back on the phone, I asked them to verify if my med had been called in.
“Yes, it was called in this morning.”
“Great, I’ll be over to pick it up in two minutes.” (I live right across the street from the pharmacy.)
“I’m sorry, you’ll have to come tomorrow, we’re closing right now.”
… If you hadn’t put me on hold for over half a freaking hour, you wouldn’t be closed.
If you could slap people over the phone, I would have.
Not to mention you might have a miraculous recovery, obviating the need for any further medication. Might happen, so in the interests of saving us money, your request for extended prescriptions is denied.
I love my 3-month-worth mail-order pharmacy! I have three very pricey psych drugs (Depakote, Lamictal and Zoloft ) and beaucoup bucks by ordering that way. It also helps that my pdoc writes me 3-months’ worth scripts with 3 refills each.
The pharmacy itself (Pharmacare) actually directs you to initially have your doc give you a one-month prescription for your local pharmacy and a 3-month one to send to them immediately, so you don’t get stuck if your first shipment’s late.
(btw, remind me to pit my bipolar disorder. I don’t even get to balance the depression with the fun “high” euphoric manias! I get “mixed episodes” where you’re just irritable and anxious and have a 90-second attention-span and a hair-trigger temper - call me the Screaming Psycho Bitch from Hell without my meds…)
Umm…make that “…save beaucoup bucks…”
Darn “quick reply” doesn’t give you the “preview” option. 
Mine, theoretically works that way. Practically - they send anywhere from two to four months, depending on how someone hapepens to feel that day. They also do not automatically refill. Refills must be called in (by me) two weeks in advance (not earlier - they won’t accept calls earlier than that). However, they don’t guarantee that they’ll send the new drugs out then. Instead you could wait anywhere from two weeks to a month before the next set happens to arrive. So there’s nearly always gaps. Not to mention the inane conversations that you have with the idiots at the company who have not mastered basic multiplication. (2/day for three months is going to be around 180. Not 90. Definitely not 60.)
I’m sure it saves the company money when no one ever gets their medication, but I’d prefer being able to go to the pharmacy. Of course, that’s not covered - only the mail order morons.
That’s so bizarre. I’m on a schedule II drug (Adderall), and for the first four months or so, my doctor had me come in every month for a check up and a new prescription, but since I changed insurance recently, I have a mail order pharmacy I can use that saves me tons of money (10 dollars for three months worth of both my generic Adderall and my birth control pill, versus 35 dollars per month for both), and I had expected my doctor to say no way when I asked if I could get a prescription for three months worth of Adderall, but it was no problem.
Yes, it does. Click on “Go Advanced” instead of “Post Quick Reply”, and it will put you into your preview page, just as though you had entered from the “Post Reply” button in the first place…
Scary situation … Both of those failures would be a violations of procedures at the PBM I work for. Which doesn’t mean they never happen, of course.
I say you start firebombing. IMHO, this shit is inexcusable! Vital meds are not something anyone in the medical profession should screw around with, give 'em to the people who need 'em, and damn the costs. That’s one of the reasons why, if I have a choice, I do not select the “HMO option” when signing up for health insurance. Sure, it can be cheaper, but studies indicate that women with breast cancer tend to have a higher mortality rate with HMOs, and I figure if they’re basically going to let women die (I realize that it’s a bit more complicated than that), then they’re probably screwing their other customers as well.
Yeah, could be. I know there with my refillable scrips, I can’t pick up refills until x days after the previous scrip was filled (e.g. for 30 days, I can pick up the next refill after 22 days or something). Sucks to not be able to get extra if you’re planning a trip or something, but that’s the nature of insurance these days.
Rilchiam’s pitting of the drugstore and the doctor’s office is well-deserved. WTF is with the doctor refusing to write a refillable scrip? It’s not like Dilantin is a controlled substance! The doctor’s office is the real culprit here!
The stories of screwups with the mail-order pharmacies make me glad for my company’s choice; I pitted its voice response system once (and it’s still pittable) but we’ve always had extremely good service otherwise, including prompt notification - usually by email, phone and snail mail, when there’s been any sort of issue.
My main gripe with my pharmacy is that they’re always running out of this one medicine I take every day and refill every month. Dammit.
Okay, I just got done with a round of phone calls. I’m still not clear on what the fuck went wrong and where.
The pharmacy’s automated system told me the scrip wasn’t ready, so I called the doctor’s office. First they told me they’d never received a fax, and they’d check on this and give me a call back. After half an hour, I called them again. I’m leaving out a lot of getting put on hold and so forth, but at one point, I was told they couldn’t find my chart, and asked when I’d last been in the office. When I said “Almost a year,” they said, “That must be why [I can’t find the chart].”
Then they told me they had reponded to the fax, on the 15th. ??? Maybe, maybe not. I had them make me an appointment for December 15th, at which time I will state my case directly to Dr. F. Then I called the pharmacy again to give them a heads-up that the office said they would call the pharm “shortly”. So presumably everyone’s on the same page here.
Grr. I try, I really try, to be polite and reasonable with Dr. F’s staff (this is not the first miscommunication, let alone the first scrip miscommunication. One time they lost the results of my blood work.) but I know my irritation is evident in my tone, even if I’m diplomatic with my words. As I said above, this is not ordering a pizza.
For comparison, in a few minutes I’m going to go to the post office to collect a package that should have been in my possession two weeks ago, but the mail carrier only deigned to drop a final notice in our mailbox on Saturday, without leaving any previous notices. This is a matter of some concern to us, since MIL sent us some mail order stuff that’s perishable, and we don’t want that festering at the post office for two weeks. But I know I won’t have any problem being diplomatic with the postal workers, because I’m not at any health risk if I don’t get a fruitcake on time. (Yeah, I know what you’re thinking, but it’s damned good fruitcake, not one of those tinned doorstops.)
So we’ll see. I will update if necessary.
Sorry, this response might be kind of long, but you asked for someone who works in a Pharmacy so I figured I’d jump in.
Your insurance is to blame if they only allow you one month’s supply at a retail pharmacy. I will fill a year’s worth of a medication (as long as it isn’t controlled and you have enough pills remaining) if you’re paying cash for it, your insurance keeps you coming back here every month. Many insurance companies want to encourage the use of mail order because they can more closely control the generic substitutions and keep a better eye on their own costs. The tradeoff is that you have to get your meds every month at a retail pharmacy.
The only thing your insurance controls is how many days worth of medicine you can get at a time, they have no control over what the doctor actually writes. Which is why your doc might write for a 90 days’ supply, where your insurance only covers 30, you still have 60 pills left on that prescription.
Since you raise an interesting point about other customers, you must be under the impression that pharmacies only ever deal with one customer at a time, or that our priority is to follow up on what is essentially your responsibility to do. We will be more than happy to call your doctor’s office, most often fax though because most offices want a paper trail of authorizations, and then it’s in your doctor’s hands. If you think that things aren’t getting communicated well enough, you need to make sure people are keeping track of your medications. At my pharmacy, we have upwards of 3000 patients with new and refill prescriptions every week. If yours doesn’t stand out for some reason, sometimes things fall through the cracks. I personally feel that patients should take more responsibility for their medication, which it sounds like you are doing, especially when it comes to a breakdown of communication on the doctor’s end. We all know that sometimes you have to prod people to get things done. When you’re essentially 1 of 3000 people whose names and prescriptions all look the same, you need to take some responsibility for that too. Not all the responsibility, mind you, but more.
Just a simple “Well I called once and it should have been taken care of” isn’t good enough, sorry. Ideally, maybe. In the real world? People get busy and overwhelmed.
Many offices have a minimum 48 hours for refill requests to be authorized, but if there is a miscommunication at your doctor’s office and they don’t send anything back to us, you should keep calling the pharmacy to have them re-fax the doctor until they respond. After all, most pharmacies have a system by which they re-fax or re-call the doctor but only after several days with no response.
In regards to why you have to go through this every month, I’d suggest that you contact your doctor and find out why they don’t want to authorize the medication for more than a month at a time. This may be an office policy, and you may want to find a new doctor.
That’s what I would suggest. Most pharmacies will advance you at least enough pills for you to get by if they see that it’s a maintenance medication and you are a regular customer there. But also understand that the pharmacy is taking a risk that you will 1) return to their pharmacy and pay for the remainder of your pills, 2) that your doctor won’t change your prescription, and 3) that you won’t go to the doctor and get a new hard copy prescription and then take it elsewere. If any of those things don’t happen, they have just lost an unretrievable amount of money.
Some states won’t allow a 90 days supply of a CII. California, (as I found out this summer) indeed does allow for it.
Let me get this straight, did you use the automated system before when you say the pharmacy “flat out lied to you” when they said it was done? Because you also need to understand that when you get a fax-back, the prescription number you have in your hand is generated to a new prescription number, one which you may have never seen before. Call and talk to someone in the pharmacy. They will check your profile for your most recent prescriptions, regardless of the Rx number on the bottle.
This also may be why your doctor has taken so long to respond to the request. Sometimes offices will fax back, writing “no refills authorized – patient must schedule office visit before rx will be released” or somesuch. This message may have been lost to you, as much as we try to facilitate communication between patient and doctor’s office; (which I feel is also not our responsibility, if the patient is going to be pissed off at us because the doctor won’t authorize the refill, why won’t the doctor’s office just call and say “we aren’t authorizing your Dilantin, please make an appointment and then we will authorize it”?), sometimes the message gets lost. Apologies.
That’s as much as I have to offer in terms of insider advice, anything else anyone would like to know about the inner workings of the mysterious pharmacy, I’d be glad to help. 
-foxy
No, that was last month, and in that instance, I did talk to a live person. I made sure to do that before I left the house, and when I arrived (the pharm is less than ten minutes away by car), then they said it wasn’t ready. Several other people were sidelined along with me, and one of them told me he had also spoken to a live person.
Okay, that’s a different scenario then. Not that I really know what the exact situation was in that pharmacy, but I’ve had to take the blame for some fucking stupid technicians who didn’t know how to interpret the information they were reading.
-foxy
There’s a difference in AU as opposed to the US, though.
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In the US, you normally aren’t handed your prescription back - it stays at the pharmacy. If you want to use it somewhere else, the pharmacy (chemist) you’re at has to call the pharmacy where you had it filled and get it transferred. Here, you’re responsible for your own prescription - keeping it with you - unless the medication is controlled somehow. Took me ages to get used to that.
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Insurance in the US is a factor. Unlike Medicare here, where most things are $28AUD or less unless its not on the PDF, in the US your private health insurance sometimes dictates what you can and cannot have at what price, how often they will pay for it, how you must have it dispensed, etc. This can vary from insurer to insurer. Some require it to be dispensed by mail from their own inhouse pharmacy, for example.
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Here - and YMMV, but in inner Sydney anyway - if you want a prescription for something, even if you are on the drug long term, you must go to the doctor and get it when it runs out. If you can talk a doctor into issuing it without you being there, they will send you the prescription, not the pharmacy. In the US is it possible to fax your doctor yourself, or for your pharmacy to fax your doctor and request a refill without you having to actually go to the doctor - this is common in my experience. (My asthma medicine, for example. I would get a script for three months, I could get the pharmacy to call/fax my doc and get another three month script, but then I had to go back or the doc wouldn’t authorise another one.) Sometimes insurance requires - apparently - that prescriptions be issued for one fill only. This means much in the way of calling and faxing back and forth. And it is as irritating as it sounds.
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Pharmacies in the US tend to be, in my experience, very much busier than pharmacies here, waiting times of over an hour are common. If I wait 10 min to get a prescription filled here, I wonder what’s going on!
Hope this helps.
Cheers,
G
I get my perscriptions through the VA medical system. Automated phone system, and they mail out the scripts. (Fex Ex for scheduled drugs) You allow 5 to 7 days for the meds to arrive. In the 4 years I’ve been dealing with them I’ve never missed a pill. They are very efficient and concerned about their patients.
I love my pharmacy (inside Stop N Shop). The pharmacists and technicians are all very nice, fast, and professional. When random idiot doctors insist on giving me Penecillian and other members of the same family - it’s the pharmacist who translates the chicken scratch for me, then call the doctor to tell them they’re idiots. When I tell a doctor that I am allergic to the penecillian family, I expect them to take that into account. When my BF tells them he can’t take Vicodin, they should not prescribe Vicodin. *What the fuck is wrong with these people?! * Anyway, the pharmacy calls me on my home phone, then cell phone, then work phone whenever there’s a problem.
I am blessed with a wonderful pharmacy. Since I always choose the most expensive PPO for my health plan, and the most expensive prescription plan, I never (had) problems with what I could and could not get. Up until a week ago, I had never even paid more than .50 for a prescription with my current plan. Then, I went back on birth control. MY FUCKING INSURANCE PLAN DOES NOT COVER BIRTH FUCKING CONTROL!!! What the fuck is up with that. And, before you ask, yes, they do cover Viagra.
I have never had them take more than 20 minutes to fill something. However, they are not open 24 hrs so I sometimes have to go to CVS. CVS took 4 fucking hours to fill a prescription for a Z-Pak. They told us it would be half an hour. It’s a prefilled blister pack. It does not require any measuring. I was already a regular customer there and my insurance had not changed. It should not have taken 4 motherfucking hours, no matter how busy they were. It was because of this that I went to Stop N Shop. My BF had to get a Z-Pak on Monday. SNS was very busy and they still had it filled within 5 minutes.